Provider Demographics
NPI:1831559897
Name:MILLION, MARY ELLEN (MS LPC)
Entity type:Individual
Prefix:
First Name:MARY ELLEN
Middle Name:
Last Name:MILLION
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 1:2513 DEER CHASE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3929
Mailing Address - Country:US
Mailing Address - Phone:405-831-1573
Mailing Address - Fax:
Practice Address - Street 1:4900 RICHMOND SQ STE 107
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2043
Practice Address - Country:US
Practice Address - Phone:405-831-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3178101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional