Provider Demographics
NPI:1912406968
Name:MURCH, CHAUNCEY MICHAEL III (LPC, NCC, BC-TMH)
Entity Type:Individual
Prefix:MR
First Name:CHAUNCEY
Middle Name:MICHAEL
Last Name:MURCH
Suffix:III
Gender:M
Credentials:LPC, NCC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5683
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-5683
Mailing Address - Country:US
Mailing Address - Phone:918-212-6333
Mailing Address - Fax:
Practice Address - Street 1:5350 S WESTERN AVE STE 708
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-4537
Practice Address - Country:US
Practice Address - Phone:918-212-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC07302101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200756720AMedicaid