Healthcare Provider Details

I. General information

NPI: 1275950529
Provider Name (Legal Business Name): AGAPE COUNSELING SERVICES, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8809 ALAMEDA DR
NORMAN OK
73026-3549
US

IV. Provider business mailing address

8809 ALAMEDA DR
NORMAN OK
73026-3549
US

V. Phone/Fax

Practice location:
  • Phone: 405-343-4244
  • Fax:
Mailing address:
  • Phone: 405-343-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2591
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2591
License Number StateOK

VIII. Authorized Official

Name: JENNIFER LADD
Title or Position: MANAGER
Credential: LCSW
Phone: 405-343-4244