Provider Demographics
NPI:1730411687
Name:CHURCHILL, RHONDA JEAN (LPC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:JEAN
Last Name:CHURCHILL
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 1:223 N SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7363
Mailing Address - Country:US
Mailing Address - Phone:918-607-3932
Mailing Address - Fax:918-492-0493
Practice Address - Street 1:223 N SUNSET AVE
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7363
Practice Address - Country:US
Practice Address - Phone:918-607-3932
Practice Address - Fax:918-492-0493
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health