Provider Demographics
NPI:1669751426
Name:THE COUNSELING OFFICES OF RANDY L CROWNOVER, LMFT, LLC
Entity type:Organization
Organization Name:THE COUNSELING OFFICES OF RANDY L CROWNOVER, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CROWNOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:405-819-1349
Mailing Address - Street 1:1700 CAMDEN WAY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2975
Mailing Address - Country:US
Mailing Address - Phone:405-819-1349
Mailing Address - Fax:
Practice Address - Street 1:3233 E MEMORIAL RD
Practice Address - Street 2:SUITE 110
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-7082
Practice Address - Country:US
Practice Address - Phone:405-819-1349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK911106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty