Provider Demographics
NPI:1902069461
Name:PUTNAM, DENISE ALINE (MS, LPC)
Entity Type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:ALINE
Last Name:PUTNAM
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 1:405 NE MYERS AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-1716
Mailing Address - Country:US
Mailing Address - Phone:918-766-5705
Mailing Address - Fax:918-331-3584
Practice Address - Street 1:700 S.W. PENN
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003
Practice Address - Country:US
Practice Address - Phone:918-337-8080
Practice Address - Fax:918-337-8099
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-05
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2308101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional