Provider Demographics
NPI:1265891899
Name:COUNSELING OFFICES OF RANDY L. CROWNOVER, LMFT, LLC
Entity type:Organization
Organization Name:COUNSELING OFFICES OF RANDY L. CROWNOVER, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWNOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:405-819-1349
Mailing Address - Street 1:4733 FIRST LIGHT LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-0819
Mailing Address - Country:US
Mailing Address - Phone:404-819-1349
Mailing Address - Fax:866-351-2284
Practice Address - Street 1:501 E 15TH ST
Practice Address - Street 2:SUITE 500A
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5043
Practice Address - Country:US
Practice Address - Phone:405-819-1349
Practice Address - Fax:866-551-2284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK911251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health