Provider Demographics
NPI:1912258526
Name:BRENT, CHRISTINA (LPC-S)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BRENT
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:MABERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 E BROADWAY CT STE E
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7931
Mailing Address - Country:US
Mailing Address - Phone:918-245-5565
Mailing Address - Fax:918-245-5564
Practice Address - Street 1:401 E BROADWAY CT STE E
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7931
Practice Address - Country:US
Practice Address - Phone:918-245-5565
Practice Address - Fax:918-245-5564
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health