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NPI Code Detail

MEDICARE: BETTY JACKSON COUNSELING SERVICES

MEDICARE: BETTY JACKSON 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) Counselor659OK
2101YP2500XProfessional Counselor3343OK

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 : 1508178070
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETTY JACKSON COUNSELING SERVICES
Provider Business Mailing Address
First Line : 200 W HOBSON AVE
Second Line :
City : SAPULPA
State : OK
Zip : 74066-3926
Country : US
Telephone Number : 918-902-5348
Fax Number : 918-340-5189
Provider Business Practice Location Address
First Line : 2508 E 71ST ST STE C
Second Line :
City : TULSA
State : OK
Zip : 74136-5572
Country : US
Telephone Number : 918-794-6570
Fax Number : 918-340-5189
Authorized Official
Title or Position : LIC BEHAVIORAL HEALTH PROFESSIONAL
Name : MS. LATIA R PARKER
Credential : LPC-S, LADC/MH
Telephone Number : 918-902-5348
Provider Enumeration Date : 07/13/2010
Last Update Date : 06/04/2026

Similar Medicare Providers

1679499545 — BLJ COUNSELING AND CONSULTING PC
Practice Location Address:
2508 E 71ST ST STE C
TULSA, OK
74136-5572
Practice Phone: 918-794-6570
Practice Fax: 918-340-5189
1669305363 — JADEN S LIPSEY BSW
Practice Location Address:
2508 E 71ST ST STE C
TULSA, OK
74136-5572
Practice Phone: 918-704-6570
Practice Fax:
1164669149 — LATIA R PARKER LADC, LPC
Practice Location Address:
2508 E 71ST ST , SUITE C
TULSA, OK
74136-5572
Practice Phone: 918-794-6570
Practice Fax: 918-340-5189
1578850483 — TAMIKA SUTTON-LIPSEY LCSW
Practice Location Address:
2508 E 71ST ST STE C
TULSA, OK
74136-5572
Practice Phone: 918-794-6570
Practice Fax:
1457602864 — MR. MICHAEL LEON MCCALISTER II MS, LPC-C
Practice Location Address:
2508 E 71ST ST STE C
TULSA, OK
74136-5572
Practice Phone: 918-794-6570
Practice Fax: 918-340-5189
1942554571 — MRS. JENNIFER LEA WINSTON
Practice Location Address:
2508 E 71ST ST STE C
TULSA, OK
74136-5572
Practice Phone: 918-794-6570
Practice Fax:

Directions to “BETTY JACKSON COUNSELING SERVICES ” Practice Location

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