Healthcare Provider Details

I. General information

NPI: 1831451715
Provider Name (Legal Business Name): DANNASUE ANN PRUETT-JONES LADC-MH, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W FORREST AVE STE A
EUFAULA OK
74432-3205
US

IV. Provider business mailing address

PO BOX 179
STIGLER OK
74462-0179
US

V. Phone/Fax

Practice location:
  • Phone: 800-640-9741
  • Fax:
Mailing address:
  • Phone: 800-640-9741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number118
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11916
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: