Healthcare Provider Details

I. General information

NPI: 1619707734
Provider Name (Legal Business Name): KEEPIN IT REAL WITH TIFFANY COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7718 E 91ST ST STE 100
TULSA OK
74133-6051
US

IV. Provider business mailing address

7718 E 91ST ST STE 100
TULSA OK
74133-6051
US

V. Phone/Fax

Practice location:
  • Phone: 918-810-6507
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY SUTTON
Title or Position: OWNER
Credential: LPC
Phone: 918-810-6507