Healthcare Provider Details

I. General information

NPI: 1245695071
Provider Name (Legal Business Name): PHOENIX COUNSELING SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2015
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 2 BOX 6745
WESTVILLE OK
74965-9420
US

IV. Provider business mailing address

RR 2 BOX 6745
WESTVILLE OK
74965-9420
US

V. Phone/Fax

Practice location:
  • Phone: 918-723-3912
  • Fax:
Mailing address:
  • Phone: 918-723-3912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARRIE BETH CURTIS
Title or Position: CASE MANAGER
Credential: BSW
Phone: 918-575-5899