Healthcare Provider Details

I. General information

NPI: 1386277481
Provider Name (Legal Business Name): PINNACLE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2020
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 MAIN ST STE 100
DEL CITY OK
73115-5508
US

IV. Provider business mailing address

5505 MAIN ST STE 100
DEL CITY OK
73115-5508
US

V. Phone/Fax

Practice location:
  • Phone: 405-812-0642
  • Fax: 405-609-6575
Mailing address:
  • Phone: 405-812-0642
  • Fax: 405-609-6575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: NAKISIA CHENEVERT
Title or Position: MENTAL HEALTH THERAPIST
Credential: LPC, LADC
Phone: 405-812-0642