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Organization

PERSONAL REVOLUTIONS BEHAVIORAL HEALTH SERVICES, LLC

Active
Other names
Krystal Haltom
Organization subpart
No

Provider details

NPI number
Authorized official
KRYSTAL DAWN HALTOM M.A., LPC SUPERVISOR (OWNER)
(405) 550-2688
Entity
Organization

Contact information

Practice address
6801 S WESTERN AVE STE 101, OKLAHOMA CITY, OK 73139-1816
(405) 550-2688
(405) 619-3924
Mailing address
6801 S WESTERN AVE STE 101, OKLAHOMA CITY, OK 73139-1816
(405) 550-2688
(405) 619-3924

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6323
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2003754400B
OK
05
200781380A
OK
Enumeration date
01/04/2018
Last updated
02/24/2026
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