Healthcare Provider Details

I. General information

NPI: 1891742367
Provider Name (Legal Business Name): SAMARITAN COUNSELING & GROWTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S MADISON BLVD
BARTLESVILLE OK
74006-2822
US

IV. Provider business mailing address

245 S MADISON BLVD
BARTLESVILLE OK
74006-2822
US

V. Phone/Fax

Practice location:
  • Phone: 918-336-1463
  • Fax: 918-331-9717
Mailing address:
  • Phone: 918-336-1463
  • Fax: 918-331-9717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KEITH SHEFFIELD
Title or Position: EXECUTIVE DIRECTOR
Credential: M.DIV., M.S., N.C.C.
Phone: 918-336-1463