The Dysfunctional Couch

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5358 Issued in OK

Legal business name

THE DYSFUNCTIONAL COUCH

Practice address

3839 S Boulevard Ste 200
Edmond, OK 73013-5495

Phone

(918) 638-4219

NPI assigned

Nov 9, 2017

Last updated

Jan 6, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth Louise Mitchell, M.ED., LPCNPI 1295019057

Title

Owner, Therapist

Phone

(918) 638-4219

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Mitchell, M.ED.

  • Professional Counselor
  • Edmond, OK
  • NPI 1295019057
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1295248425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 S BOULEVARD STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135495",
            "telephone_number": "918-638-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3839 S BOULEVARD STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135495",
            "telephone_number": "918-638-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DYSFUNCTIONAL COUCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2023-01-06",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "918-638-4219",
        "authorized_official_credential": "M.ED., LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200389800B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Edmond, OK
• Providers in Edmond, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.