Provider Demographics
NPI:1144897125
Name:PASSMORE, CHRISTOPHER (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:PASSMORE
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 1:1439 E 55TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6946
Mailing Address - Country:US
Mailing Address - Phone:918-202-6161
Mailing Address - Fax:
Practice Address - Street 1:12834 OLD US 169
Practice Address - Street 2:
Practice Address - City:OOLOGAH
Practice Address - State:OK
Practice Address - Zip Code:74053-7405
Practice Address - Country:US
Practice Address - Phone:918-695-2059
Practice Address - Fax:918-221-7975
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11267101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional