Healthcare Provider Details
I. General information
NPI: 1295072106
Provider Name (Legal Business Name): COUNSELING INSIGHT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2013
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6307 WATERFORD BLVD STE 127
OKLAHOMA CITY OK
73118-1125
US
IV. Provider business mailing address
6307 WATERFORD BLVD STE 127
OKLAHOMA CITY OK
73118-1125
US
V. Phone/Fax
- Phone: 405-778-1847
- Fax: 888-742-7095
- Phone: 405-778-1847
- Fax: 888-742-7095
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 1816 |
| License Number State | OK |
VIII. Authorized Official
Name:
SHERRY
DAWN
DRIGGS
Title or Position: PRESIDENT
Credential: LPC
Phone: 405-778-1847