MEDICARE: NEXT STEP COUNSEING AGENCY

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1598031809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXT STEP COUNSEING AGENCY

Provider Business Mailing Address
First Line	:	840 N.W. 115ST.
Second Line	:	840 N.W. 115ST.
City	:	OKLAHOMA
State	:	OK
Zip	:	73114-6900
Country	:	US
Telephone Number	:	405-751-8701
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 NW 115TH ST
Second Line	:	840 N.W. 115ST.
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-6900
Country	:	US
Telephone Number	:	405-751-8701
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ALFONZO MCMILLIAN
Credential	:
Telephone Number	:	405-424-0007

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	03/30/2012

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