Provider Demographics
NPI:1104968346
Name:TROY, BILLY EUGENE (LPC)
Entity type:Individual
Prefix:MR
First Name:BILLY
Middle Name:EUGENE
Last Name:TROY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 NW FERRIS AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-5626
Mailing Address - Country:US
Mailing Address - Phone:580-699-8300
Mailing Address - Fax:
Practice Address - Street 1:1930 NW FERRIS AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-5626
Practice Address - Country:US
Practice Address - Phone:580-699-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3716101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200295250 AMedicaid