Healthcare Provider Details

I. General information

NPI: 1386751485
Provider Name (Legal Business Name): CENTER FOR COUNSELING AND EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 S UTICA AVE
TULSA OK
74104-4213
US

IV. Provider business mailing address

2761 E SKELLY DR SUITE 700
TULSA OK
74105-6232
US

V. Phone/Fax

Practice location:
  • Phone: 918-295-8692
  • Fax: 918-592-5789
Mailing address:
  • Phone: 918-747-6800
  • Fax: 918-592-5789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number2246
License Number StateOK

VIII. Authorized Official

Name: DR. CLYDE GLANDON
Title or Position: DIRECTOR
Credential: PHD
Phone: 918-747-6800