MEDICARE: RELIANT 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1306252655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIANT COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	5350 S WESTERN AVE STE 316
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109-4530
Country	:	US
Telephone Number	:	405-225-1969
Fax Number	:

Provider Business Practice Location Address
First Line	:	5350 S WESTERN AVE STE 316
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109-4530
Country	:	US
Telephone Number	:	405-225-1969
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JULIUS O AKHIGBE
Credential	:	MHR
Telephone Number	:	405-219-4809

Provider Enumeration Date	:	07/08/2014
Last Update Date	:	07/08/2014

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