DR. Charles Michael Kissick, LADC, LPC, ICAADC

NPI #1972744639 in Guthrie, Oklahoma

Provider Information

NPI Number: 1972744639
Entity Type: Individual
Name: DR. Charles Michael Kissick, LADC, LPC, ICAADC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: LADC, LPC, ICAADC
Enumeration Date: Mar 10, 2009
Last Updated: Aug 20, 2024

Practice Location

Address: 4000 E CHARTER OAK RD
City: Guthrie
State: Oklahoma
ZIP Code: 73044-9350
Phone: (405) 466-8155

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor	101Y00000X	Primary

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