Lillian Kay Johndrow, LPC, LBP, LADC

Individual provider Active NPI Professional Counselor · Nowata, OK

NPI 1508037581 · NPPES record last updated Mar 18, 2008

Key facts

NPI
1508037581
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
1939 (OK)
Practice address
1020 Lenape Drive
Nowata, OK 75048
Phone
(918) 273-7504
Fax
(918) 273-3451
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
554OKMDPsychologist
14OKMDAnesthesiologist Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 554 OK
Mental Health Counselor 101YM0800X 14 OK
Professional Counselor 101YP2500X 1939 OK Yes

Addresses

Primary practice location

1020 Lenape Drive
Nowata, OK 75048

Mailing address

1020 Lenape Drive
Nowata, OK 75048
Phone (918) 273-7504

Other providers in Nowata, OK

All providers in Nowata, OK · Professional Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.