Provider Demographics
NPI:1235297565
Name:HOUX, JEANNINE (RC)
Entity type:Individual
Prefix:
First Name:JEANNINE
Middle Name:
Last Name:HOUX
Suffix:
Gender:F
Credentials:RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 DOVE TREE LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1917
Mailing Address - Country:US
Mailing Address - Phone:405-401-6660
Mailing Address - Fax:
Practice Address - Street 1:TRANSFORMING LIFE COUNSELING CENTER
Practice Address - Street 2:16301 SONOMA PARK DRIVE
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2091
Practice Address - Country:US
Practice Address - Phone:405-401-6660
Practice Address - Fax:405-562-1451
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00051900101Y00000X
OK3241101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200360720Medicaid
WA8040172OtherL&I
OK3241OtherLPC