Healthcare Provider Details

I. General information

NPI: 1831900984
Provider Name (Legal Business Name): PERSPECTIVE COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S 5TH ST STE 170
YUKON OK
73099-2658
US

IV. Provider business mailing address

110 S 5TH ST STE 170
YUKON OK
73099-2658
US

V. Phone/Fax

Practice location:
  • Phone: 405-850-6066
  • Fax:
Mailing address:
  • Phone: 405-850-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: NAOMI BRADLEY
Title or Position: PART OWNER/ THERAPIST
Credential: LPC
Phone: 405-301-3509