Provider Demographics
NPI:1295952240
Name:GREENWOOD, CAROLYN JEAN (LMFT, LADC)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:JEAN
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 LINWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-5022
Mailing Address - Country:US
Mailing Address - Phone:405-601-0295
Mailing Address - Fax:405-601-0316
Practice Address - Street 1:1418 LINWOOD BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-5022
Practice Address - Country:US
Practice Address - Phone:405-601-0295
Practice Address - Fax:405-601-0316
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK516101YA0400X
OK835106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)