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General NPI Number Information
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NPI Number | 1780033035
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Entity Type | Organization
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Legal Business Name | CST, LLC
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 1741 W 33RD ST SUITE 100
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City | EDMOND
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State | OK
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Zip | 73013-3837
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Country | US
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Telephone | 405-696-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 17304 GROVE HILL TER
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City | EDMOND
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State | OK
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Zip | 73012-9706
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Country | US
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Telephone | 405-696-9444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHERYL S THURMAN
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Credential | LPC, LMFT
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Telephone | 405-696-9444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1056
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4794
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License Number State | OK
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