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NPI Code Detail

MEDICARE: NORTHTULSA COUNSELING SERVICES, LLC

MEDICARE: NORTHTULSA COUNSELING SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyOK

General Provider Information

NPI Number : 1205140175
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHTULSA COUNSELING SERVICES, LLC
Provider Business Mailing Address
First Line : PO BOX 480843
Second Line :
City : TULSA
State : OK
Zip : 74148-0843
Country : US
Telephone Number : 918-794-0197
Fax Number : 918-794-0196
Provider Business Practice Location Address
First Line : 2625 N PEORIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-2512
Country : US
Telephone Number : 918-794-0197
Fax Number : 918-794-0196
Authorized Official
Title or Position : PRESIDENT
Name : MS. SHELIA B. THOMPSON
Credential : LPC
Telephone Number : 918-794-0197
Provider Enumeration Date : 08/03/2010
Last Update Date : 05/02/2011

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Directions to “NORTHTULSA COUNSELING SERVICES, LLC ” Practice Location

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