Healthcare Provider Details

I. General information

NPI: 1588951925
Provider Name (Legal Business Name): CENTER FOR COUNSELING AND EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4803 S LEWIS AVE
TULSA OK
74105-5154
US

IV. Provider business mailing address

4803 S LEWIS AVE
TULSA OK
74105-5154
US

V. Phone/Fax

Practice location:
  • Phone: 918-747-6800
  • Fax: 918-516-0401
Mailing address:
  • Phone: 918-747-6800
  • Fax: 918-516-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. TOM R SANDERS
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC
Phone: 918-747-6800