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General NPI Number Information
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NPI Number | 1780470898
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Entity Type | Organization
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Legal Business Name | SMALL TOWN BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 321 S 3RD ST STE 4
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City | MCALESTER
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State | OK
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Zip | 74501-5410
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Country | US
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Telephone | 918-221-7824
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Fax |
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Provider Business Mailing Address
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Address Line | 321 S 3RD ST STE 4
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City | MCALESTER
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State | OK
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Zip | 74501-5410
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Country | US
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Telephone | 918-221-7824
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | CRISTY ROBERTS
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Credential | LPC-S, RPT
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Telephone | 405-880-3409
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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 |
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License Number State |
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