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General NPI Number Information
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NPI Number | 1528481827
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Entity Type | Organization
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Legal Business Name | ANCHORED BEHAVIORAL HEALTH CONSULTING, LLC
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Dates
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Enumeration Date | 01/23/2014
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Last Update Date | 01/23/2014
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Provider Practice Location Address
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Address Line | 115 W 5TH ST 1404
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City | TULSA
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State | OK
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Zip | 74103-4239
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Country | US
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Telephone | 918-630-4506
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Fax |
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Provider Business Mailing Address
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Address Line | 115 W 5TH ST 1404
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City | TULSA
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State | OK
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Zip | 74103-4239
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Country | US
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Telephone | 918-630-4506
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JILL RENAE SEDLACEK
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Credential | M.H.R., L.P.C
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Telephone | 918-630-4506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5084
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License Number State | OK
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