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NPI 1821326406

NPI 1821326406 : ASSOCIATED COUNSELING SERVICES, INC. : YUKON, OK

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General NPI Number Information
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    NPI Number           |    1821326406
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    Entity Type          |    Organization 
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    Legal Business Name  |    ASSOCIATED COUNSELING SERVICES, INC. 
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Dates
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    Enumeration Date     |    11/19/2009
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    Last Update Date     |    11/19/2009
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Provider Practice Location Address
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    Address Line         |    508 W VANDAMENT AVE SUITE 205
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    City                 |    YUKON
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    State                |    OK
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    Zip                  |    73099-4655
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    Country              |    US
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    Telephone            |    405-350-6644
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    508 W VANDAMENT AVE SUITE 205
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    City                 |    YUKON
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    State                |    OK
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    Zip                  |    73099-4655
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    Country              |    US
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    Telephone            |    405-350-6644
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LICENSED PROFESSIONAL COUNSELOR
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    Name                 |     CHERYL ANN ROBINSON 
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    Credential           |    LPC
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    Telephone            |    405-350-6644
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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       |    1196
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    License Number State |    OK
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