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General NPI Number Information
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NPI Number | 1740316249
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Entity Type | Organization
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Legal Business Name | FIRM FOUNDATIONS VISITATION & COUNCELING CENTER INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 221 A WEST 14TH
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City | ADA
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State | OK
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Zip | 74820-6415
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Country | US
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Telephone | 580-427-3476
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Fax | 580-427-3477
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Provider Business Mailing Address
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Address Line | 221 A WEST 14TH
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City | ADA
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State | OK
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Zip | 74820-6415
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Country | US
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Telephone | 580-427-3476
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Fax | 580-427-3477
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MRS. NANCY CAROL WHITSON
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Credential | LPC
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Telephone | 580-427-3476
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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 | 3326
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License Number State | OK
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