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NPI Code Detail

MEDICARE: QUAPAW COUNSELING SERVICES

MEDICARE: QUAPAW COUNSELING SERVICES
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
1101YA0400XAddiction (Substance Use Disorder) CounselorOK

General Provider Information

NPI Number : 1457311458
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUAPAW COUNSELING SERVICES
Provider Business Mailing Address
First Line : PO BOX 876
Second Line :
City : MIAMI
State : OK
Zip : 74355-0876
Country : US
Telephone Number : 918-542-1786
Fax Number : 918-674-2334
Provider Business Practice Location Address
First Line : 58150 E 66 RD
Second Line :
City : MIAMI
State : OK
Zip : 74354-6509
Country : US
Telephone Number : 918-542-1786
Fax Number :
Authorized Official
Title or Position : DIRECTOR, QCS
Name : MR. JACOB RONALD WHITE
Credential : EMT-P
Telephone Number : 918-542-1786
Provider Enumeration Date : 03/24/2006
Last Update Date : 12/08/2025

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Directions to “QUAPAW COUNSELING SERVICES ” Practice Location

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