Healthcare Provider Details

I. General information

NPI: 1922316819
Provider Name (Legal Business Name): COUNSELING SOLUTIONS & INTERVENTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 N CLASSEN BLVD SUITE 214
OKLAHOMA CITY OK
73106-6835
US

IV. Provider business mailing address

1330 N CLASSEN BVLD 214
OKLAHOMA CITY OK
73106
US

V. Phone/Fax

Practice location:
  • Phone: 405-601-6710
  • Fax:
Mailing address:
  • Phone: 405-601-6710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number4417
License Number StateOK

VIII. Authorized Official

Name: MR. SHERMAN E JOHNSON
Title or Position: DIRECTOR
Credential: LPC
Phone: 405-601-6710