Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | LPC-6150 | OK |
Y | 101YP2500X | Professional Counselor | LPC-6150 | OK |
NPI | 1326594235 |
---|---|
Provider Name | Mr. Caleb D. Mckean |
First Address | Edmond, OK 73003-5655 |
Second Address | Oklahoma City, OK 73120-6336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2016 |
Last Update Date | 30/08/2016 |