Provider Demographics
NPI:1295325546
Name:OAK CREEK FAMILY COUNSELING
Entity type:Organization
Organization Name:OAK CREEK FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPTIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-230-2984
Mailing Address - Street 1:7792 HIGHWAY 527
Mailing Address - Street 2:
Mailing Address - City:DOYLINE
Mailing Address - State:LA
Mailing Address - Zip Code:71023-3456
Mailing Address - Country:US
Mailing Address - Phone:318-230-2984
Mailing Address - Fax:
Practice Address - Street 1:7792 HIGHWAY 527
Practice Address - Street 2:
Practice Address - City:DOYLINE
Practice Address - State:LA
Practice Address - Zip Code:71023-3456
Practice Address - Country:US
Practice Address - Phone:318-230-2984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty