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Organization

EDMONDSON COUNSELING SERVICES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CONNIE CUNNINGHAM EDMONDSON LCSW (LICENSED CLINICAL SOCIAL WORKER)
(405) 843-1551
Entity
Organization

Contact information

Practice address
5009 N PENNSYLVANIA AVE, STE. 116, OKLAHOMA CITY, OK 73112-8887
(405) 843-1551
(405) 843-1494
Mailing address
5009 N PENNSYLVANIA AVE, STE. 116, OKLAHOMA CITY, OK 73112-8887
(405) 843-1551
(405) 843-1494

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1508
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
448602140002
BLUE CROSS BLUE SHIELD
OK
Enumeration date
11/30/2006
Last updated
06/17/2011
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