Healthcare Provider Details

I. General information

NPI: 1346174117
Provider Name (Legal Business Name): MIND MANAGEMENT COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SE B ST
STIGLER OK
74462-2425
US

IV. Provider business mailing address

1304 NW MIMOSA DR
STIGLER OK
74462-1865
US

V. Phone/Fax

Practice location:
  • Phone: 918-470-0457
  • Fax:
Mailing address:
  • Phone: 918-470-0457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE GUTHRIE
Title or Position: CO-OWNER
Credential: LPC
Phone: 918-470-0457