MEDICARE: DESIRE 2 BE YOU COUNSELING SERVICES, LLC

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	6452	OK

General Provider Information

NPI Number	:	1649706672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESIRE 2 BE YOU COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	9075 HARMONY DR
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6217
Country	:	US
Telephone Number	:	405-361-4823
Fax Number	:

Provider Business Practice Location Address
First Line	:	9075 HARMONY DR
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6217
Country	:	US
Telephone Number	:	405-361-4823
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MRS. ALICIA NICOLE MURPHY
Credential	:	MHR, LPC
Telephone Number	:	405-361-4823

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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