Provider Demographics
NPI:1265764989
Name:MACOTO, ALETIA EARLENE (LPC)
Entity type:Individual
Prefix:MS
First Name:ALETIA
Middle Name:EARLENE
Last Name:MACOTO
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 1:1507 JULIE PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-3840
Mailing Address - Country:US
Mailing Address - Phone:405-243-7873
Mailing Address - Fax:405-848-5619
Practice Address - Street 1:1507 JULIE PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-3840
Practice Address - Country:US
Practice Address - Phone:405-243-7873
Practice Address - Fax:405-848-5619
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2128101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional