Elements of Life Counseling Center, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4164 Issued in OK

Legal business name

ELEMENTS OF LIFE COUNSELING CENTER, LLC

Practice address

1741 W 33Rd St
Suite 100
Edmond, OK 73013-3837

Phone

(405) 285-5586

Fax

(405) 562-4858

NPI assigned

Oct 31, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Terri Tarrant Slack, LPC, LADC

Title

Owner

Phone

(405) 401-1464

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1710382866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 W 33RD ST",
            "address_2": "SUITE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133837",
            "telephone_number": "405-285-5586",
            "fax_number": "405-562-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 W 33RD ST",
            "address_2": "SUITE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133837",
            "telephone_number": "405-285-5586",
            "fax_number": "405-562-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTS OF LIFE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "TARRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-401-1464",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "638",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4164",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 31, 2014; 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.