Healthcare Provider Details

I. General information

NPI: 1003855925
Provider Name (Legal Business Name): MULTI-COUNTY COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W MAIN ST
PURCELL OK
73080-4220
US

IV. Provider business mailing address

PO BOX 662
PURCELL OK
73080-0662
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-1785
  • Fax: 405-527-1084
Mailing address:
  • Phone: 405-527-1785
  • Fax: 405-527-1084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GREGG JOHNSON
Title or Position: OWNER
Credential: MPH
Phone: 405-527-1785