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General NPI Number Information
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NPI Number | 1902712045
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Entity Type | Organization
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Legal Business Name | BRIGHT LIVES COUNSELING
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 6372 S 80TH EAST AVE APT A
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City | TULSA
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State | OK
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Zip | 74133-3847
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Country | US
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Telephone | 918-200-2037
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Fax | 918-818-3973
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Provider Business Mailing Address
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Address Line | 6372 S 80TH EAST AVE APT A
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City | TULSA
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State | OK
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Zip | 74133-3847
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Country | US
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Telephone | 918-200-2037
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Fax | 918-818-3973
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Authorized Official
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Title or Position | OWNER/OPERATOR/LPC
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Name | MARY MOULTON
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Credential | MS, LPC
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Telephone | 918-200-2037
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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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