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General NPI Number Information
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NPI Number | 1457311458
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Entity Type | Organization
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Legal Business Name | QUAPAW COUNSELING SERVICES
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 58150 E 66 RD
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City | MIAMI
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State | OK
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Zip | 74354-6509
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Country | US
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Telephone | 918-542-1786
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 876
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City | MIAMI
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State | OK
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Zip | 74355-0876
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Country | US
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Telephone | 918-542-1786
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Fax | 918-674-2334
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Authorized Official
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Title or Position | DIRECTOR, QCS
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Name | MR. JACOB RONALD WHITE
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Credential | EMT-P
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Telephone | 918-542-1786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | OK
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