Healthcare Provider Details

I. General information

NPI: 1922318468
Provider Name (Legal Business Name): CENTER FOR COUNSELING AND EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 S PITTSBURG AVE
TULSA OK
74112-1201
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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TOM SANDERS
Title or Position: THERAPIST
Credential:
Phone: 918-747-6800