Provider Demographics
NPI:1669249827
Name:MAULDIN COUNSELING
Entity type:Organization
Organization Name:MAULDIN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAULDIN-LOOBY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-694-0553
Mailing Address - Street 1:701 CEDAR LAKE BLVD STE 142
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7817
Mailing Address - Country:US
Mailing Address - Phone:405-694-0553
Mailing Address - Fax:
Practice Address - Street 1:701 CEDAR LAKE BLVD STE 142
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-7817
Practice Address - Country:US
Practice Address - Phone:405-694-0553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty