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General NPI Number Information
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NPI Number | 1467022392
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Entity Type | Organization
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Legal Business Name | SAGACITY COUNSELING AND NEUROTHERAPEUTIC SOLUTIONS LLC
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 7902 FERN MOUNTAIN RD
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City | MUSKOGEE
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State | OK
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Zip | 74401-7207
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Country | US
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Telephone | 479-276-8871
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Fax |
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Provider Business Mailing Address
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Address Line | 915 DENISON ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-5932
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Country | US
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Telephone | 479-276-8871
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEONARD SAUNDERS SSHEPHERD
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Credential | M.S. LPC
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Telephone | 918-609-2878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #6
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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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