Organization
EDMOND FAMILY COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE L SHAW LPC, LMFT (EXECUTIVE DIRECTOR)
(405) 341-3554
Entity
Organization
Contact information
Practice address
1251 N BROADWAY, SUITE C, EDMOND, OK 73034-3616
(405) 341-3554
(405) 341-3511
Mailing address
1251 N BROADWAY, SUITE C, EDMOND, OK 73034-3616
(405) 341-3554
(405) 341-3511
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/27/2007
Last updated
08/22/2020
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