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General NPI Number Information
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NPI Number | 1235867607
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Entity Type | Organization
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Legal Business Name | META MENTAL HEALTH LLC
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 218 E CENTRAL AVE STE A
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City | MIAMI
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State | OK
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Zip | 74354-7013
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Country | US
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Telephone | 918-919-3298
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Fax |
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Provider Business Mailing Address
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Address Line | 218 E CENTRAL AVE STE A
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City | MIAMI
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State | OK
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Zip | 74354-7013
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Country | US
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Telephone | 918-919-3298
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | CARLA WOLF
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Credential | LPC
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Telephone | 417-621-5965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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