Provider Demographics
NPI:1215940267
Name:GOODGAME, LOIS SYDONIE (MS, LPC)
Entity type:Individual
Prefix:MISS
First Name:LOIS
Middle Name:SYDONIE
Last Name:GOODGAME
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2053 W LINDSEY ST APT H
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4148
Mailing Address - Country:US
Mailing Address - Phone:405-701-5997
Mailing Address - Fax:
Practice Address - Street 1:724 24TH AVE NW STE 210
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6214
Practice Address - Country:US
Practice Address - Phone:405-321-7180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC 3267101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor