Healthcare Provider Details

I. General information

NPI: 1356628804
Provider Name (Legal Business Name): NORTH TULSA COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 N PEORIA AVE
TULSA OK
74106-2512
US

IV. Provider business mailing address

2625 N PEORIA AVE
TULSA OK
74106-2512
US

V. Phone/Fax

Practice location:
  • Phone: 918-794-0197
  • Fax: 918-794-0196
Mailing address:
  • Phone: 918-794-0197
  • Fax: 918-794-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SHELIA B THOMPSON
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC
Phone: 918-794-0197