Provider Demographics
NPI:1295940609
Name:AKINS, COURTNEY L (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:L
Last Name:AKINS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:HEAVENER
Mailing Address - State:OK
Mailing Address - Zip Code:74937-0846
Mailing Address - Country:US
Mailing Address - Phone:918-653-7718
Mailing Address - Fax:918-653-7279
Practice Address - Street 1:511 E 2ND ST
Practice Address - Street 2:
Practice Address - City:HEAVENER
Practice Address - State:OK
Practice Address - Zip Code:74937-3419
Practice Address - Country:US
Practice Address - Phone:918-653-7718
Practice Address - Fax:918-653-7279
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OK5352101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker