Provider Demographics
NPI:1205343340
Name:MACDOUGALL, KATHERINE ERIN (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ERIN
Last Name:MACDOUGALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4416 NW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-1583
Mailing Address - Country:US
Mailing Address - Phone:405-664-3960
Mailing Address - Fax:
Practice Address - Street 1:11209 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6351
Practice Address - Country:US
Practice Address - Phone:405-664-3960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2019-07-24
Deactivation Date:2019-06-12
Deactivation Code:
Reactivation Date:2019-07-24
Provider Licenses
StateLicense IDTaxonomies
OK7119101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor