Organization
N-SIDEOUT COUNSELING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE LOUDERMILK LPC (CLINICAL DIRECTOR)
(405) 606-2880
Entity
Organization
Contact information
Practice address
1330 N CLASSEN BLVD STE 315, OKLAHOMA CITY, OK 73106-6834
(405) 606-2880
(405) 606-2881
Mailing address
1330 N CLASSEN BLVD STE 315, OKLAHOMA CITY, OK 73106-6834
(405) 606-2880
(405) 606-2881
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5120
OK
101YM0800X
Mental Health Counselor
Primary
5120
OK
101YP2500X
Professional Counselor
5120
OK
102L00000X
Psychoanalyst
5120
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200412190B
—
OK
Enumeration date
06/02/2015
Last updated
06/02/2015
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