=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700576600
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A STRONGER YOU COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2023
-----------------------------------------------------
Last Update Date | 05/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3736 DEESE RD
-----------------------------------------------------
City | SPRINGER
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73458-8076
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-222-7156
-----------------------------------------------------
Fax | 580-297-9216
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3736 DEESE RD
-----------------------------------------------------
City | SPRINGER
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73458-8076
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-222-7156
-----------------------------------------------------
Fax | 580-297-9216
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MONA CUNNINGHAM
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 580-222-7156
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------