Provider Demographics
NPI:1194261818
Name:EPIPHANY COUNSELING AND CASE MANAGEMENT SERVICES LLC
Entity type:Organization
Organization Name:EPIPHANY COUNSELING AND CASE MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:NATALIE
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MAMFT
Authorized Official - Phone:405-416-3442
Mailing Address - Street 1:60036 N ROBINSON AVE
Mailing Address - Street 2:SUIT 101
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118
Mailing Address - Country:US
Mailing Address - Phone:405-416-3442
Mailing Address - Fax:
Practice Address - Street 1:6003 N ROBINSON AVE
Practice Address - Street 2:SUIT 101
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-7425
Practice Address - Country:US
Practice Address - Phone:405-416-3442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6247251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health