Provider Demographics
NPI:1144549270
Name:PHELPS, SHELLEY OZIO (LPC)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:OZIO
Last Name:PHELPS
Suffix:
Gender:F
Credentials:LPC
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Other - Credentials:
Mailing Address - Street 1:5002 SW LEE BLVD
Mailing Address - Street 2:STE. 44 CHRISTIAN FAMILY COUNSELING CENTER INC
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-8320
Mailing Address - Country:US
Mailing Address - Phone:580-531-4512
Mailing Address - Fax:580-531-4519
Practice Address - Street 1:5002 SW LEE BLVD
Practice Address - Street 2:STE 44 CHRISTIAN FAMILY COUNSELING CENTER, INC.
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8320
Practice Address - Country:US
Practice Address - Phone:580-531-4512
Practice Address - Fax:580-531-4519
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKLPC2374101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2374OtherLPC