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NPI Code Detail

MEDICARE: MAXIMUS COUNSELING INC

MEDICARE: MAXIMUS COUNSELING 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
1251S00000XCommunity/Behavioral Health AgencyOK

General Provider Information

NPI Number : 1902074065
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAXIMUS COUNSELING INC
Provider Business Mailing Address
First Line : 5714 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-4515
Country : US
Telephone Number : 405-601-1154
Fax Number : 405-601-1183
Provider Business Practice Location Address
First Line : 5714 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-4515
Country : US
Telephone Number : 405-601-1154
Fax Number : 405-601-1183
Authorized Official
Title or Position : EXECUTIVE DIRECTER
Name : MR. FEMI SOMADE
Credential : MHR, LADC
Telephone Number : 405-601-1154
Provider Enumeration Date : 02/12/2008
Last Update Date : 02/12/2008

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Directions to “MAXIMUS COUNSELING INC ” Practice Location

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