Provider Demographics
NPI:1841548526
Name:CLIBURN COUNSELING, PLLC
Entity type:Organization
Organization Name:CLIBURN COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:B.
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:CLIBURN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-306-1883
Mailing Address - Street 1:P.O. BOX 5613
Mailing Address - Street 2:CLIBURN COUNSELING, PLLC
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-5613
Mailing Address - Country:US
Mailing Address - Phone:405-306-1883
Mailing Address - Fax:405-475-9456
Practice Address - Street 1:1000 WEST WILSHIRE
Practice Address - Street 2:BLDG 3, SUITE 310
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7030
Practice Address - Country:US
Practice Address - Phone:405-306-1883
Practice Address - Fax:405-475-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty