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NPI Code Detail

MEDICARE: ENID COUNSELING & DIAGNOSTIC CENTER, INC

MEDICARE: ENID COUNSELING & DIAGNOSTIC CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2103TC0700XClinical Psychologist821OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124132253
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENID COUNSELING & DIAGNOSTIC CENTER, INC
Provider Business Mailing Address
First Line : 230 W MAPLE AVE
Second Line :
City : ENID
State : OK
Zip : 73701-4012
Country : US
Telephone Number : 580-242-5544
Fax Number : 580-233-8905
Provider Business Practice Location Address
First Line : 230 W MAPLE AVE
Second Line :
City : ENID
State : OK
Zip : 73701-4012
Country : US
Telephone Number : 580-242-5544
Fax Number : 580-233-8905
Authorized Official
Title or Position : PRESIDENT
Name : DR. WENDI L. BETZ
Credential : PHD.
Telephone Number : 580-242-5544
Provider Enumeration Date : 08/18/2006
Last Update Date : 06/01/2011

Similar Medicare Providers

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Practice Location Address:
230 W MAPLE AVE
ENID, OK
73701-4012
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1033222120 — DR. WENDI L BETZ PHD.
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1659486694 — DR. DEBORAH K GREEN D.MIN, LPC
Practice Location Address:
230 W MAPLE AVE
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73701-4012
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1033225651 — JENNIFER DAWN MCCREIGHT
Practice Location Address:
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73701-4012
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1760591978 — MALISSA LAVERN SINGLETON BS
Practice Location Address:
230 W MAPLE AVE
ENID, OK
73701-4012
Practice Phone: 580-242-5544
Practice Fax: 580-233-8905

Directions to “ENID COUNSELING & DIAGNOSTIC CENTER, INC ” Practice Location

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