Individual
JODELL LYNN MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, LMHC
Contact information
Practice address
14201 N KENTUCKY AVE, 314, OKLAHOMA CITY, OK 73134
(405) 417-4541
Mailing address
14201 N KENTUCKY AVE, OKLAHOMA CITY, OK 73134-3427
(405) 417-4541
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6583
OK
101YM0800X
Mental Health Counselor
Primary
LH61095791
WA
101YP2500X
Professional Counselor
6583
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477250716
—
WY
Enumeration date
03/07/2006
Last updated
03/09/2026
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