Provider Demographics
NPI:1902573579
Name:WINN, OKETA (LPC)
Entity Type:Individual
Prefix:MISS
First Name:OKETA
Middle Name:
Last Name:WINN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11208 RANCH ACRES TRL
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-4839
Mailing Address - Country:US
Mailing Address - Phone:804-822-8983
Mailing Address - Fax:
Practice Address - Street 1:11208 RANCH ACRES TRL
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-4839
Practice Address - Country:US
Practice Address - Phone:804-822-8983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty