Individual
KIMBERLY MCCUTCHEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHR, LPC, CCTP-II
Contact information
Practice address
17520 THUNDERBIRD HILLS RD, NEWALLA, OK 74857-9438
(405) 481-3022
Mailing address
17520 THUNDERBIRD HILLS RD, NEWALLA, OK 74857-9438
(405) 481-3022
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC05726
OK
101YM0800X
Mental Health Counselor
LPC05726
OK
101YP2500X
Professional Counselor
Primary
LPC05726
OK
Other
Enumeration date
10/01/2012
Last updated
09/13/2024
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