Provider Demographics
NPI:1285832915
Name:CABANISS, ABIGAIL MAREE (LPC UNDER SUPERVISIO)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MAREE
Last Name:CABANISS
Suffix:
Gender:F
Credentials:LPC UNDER SUPERVISIO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1262 AUGUSTA CT
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-0500
Mailing Address - Country:US
Mailing Address - Phone:405-528-8686
Mailing Address - Fax:405-528-8692
Practice Address - Street 1:1262 AUGUSTA CT
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-0500
Practice Address - Country:US
Practice Address - Phone:405-528-8686
Practice Address - Fax:405-528-8692
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health