Healthcare Provider Details

I. General information

NPI: 1992453609
Provider Name (Legal Business Name): BRIGHTER HORIZONS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N ELM PL STE N
BROKEN ARROW OK
74012-3883
US

IV. Provider business mailing address

2928 N FERN CT
BROKEN ARROW OK
74012-0834
US

V. Phone/Fax

Practice location:
  • Phone: 539-589-1529
  • Fax:
Mailing address:
  • Phone: 539-589-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MELISSA GANTZ
Title or Position: OWNER
Credential: LCSW
Phone: 539-589-1529