Provider Demographics
NPI:1912298795
Name:ACKERMAN, LAWRENCE M (LPC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:ACKERMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5408 N MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-1556
Mailing Address - Country:US
Mailing Address - Phone:405-881-6936
Mailing Address - Fax:
Practice Address - Street 1:5708 NW 132ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-4430
Practice Address - Country:US
Practice Address - Phone:405-881-6936
Practice Address - Fax:405-601-5682
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2901101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional