Healthcare Provider Details

I. General information

NPI: 1063117497
Provider Name (Legal Business Name): INFINITY COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E APACHE ST
TULSA OK
74106-3702
US

IV. Provider business mailing address

240 E APACHE ST
TULSA OK
74106-3702
US

V. Phone/Fax

Practice location:
  • Phone: 918-852-5623
  • Fax:
Mailing address:
  • Phone: 918-794-0197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHELIA BEATTY
Title or Position: LPC
Credential:
Phone: 918-794-0197