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General NPI Number Information
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NPI Number | 1659689966
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Entity Type | Organization
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Legal Business Name | SEASONS COUNSELING AND CONSULTATION PLLC
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 1590 HWY 9 EAST
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City | EUFAULA
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State | OK
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Zip | 74432-1590
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Country | US
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Telephone | 918-689-7099
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 HWY 9 EAST
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City | EUFAULA
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State | OK
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Zip | 74432-1590
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Country | US
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Telephone | 918-689-7099
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SAMANTHA L PRYOR
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Credential | MSW, LCSW
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Telephone | 918-617-2845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2809
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License Number State | OK
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