Provider Demographics
NPI:1881872125
Name:MAINS, PENNY KAY (LMFT CANDIDATE)
Entity type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:KAY
Last Name:MAINS
Suffix:
Gender:F
Credentials:LMFT CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6917
Mailing Address - Country:US
Mailing Address - Phone:405-735-9732
Mailing Address - Fax:
Practice Address - Street 1:9700 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6917
Practice Address - Country:US
Practice Address - Phone:405-735-9732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health