MEDICARE: WINDMILL COUNSELING

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1982162244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINDMILL COUNSELING

Provider Business Mailing Address
First Line	:	1319 W MOUNTAIN HEIGHTS RD
Second Line	:
City	:	FORT COBB
State	:	OK
Zip	:	73038-5816
Country	:	US
Telephone Number	:	405-668-0147
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 N. HAZLETT
Second Line	:
City	:	FORT COBB
State	:	OK
Zip	:	73038
Country	:	US
Telephone Number	:	405-668-0147
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/COUNSELOR
Name	:	RONDA JANETTE WEAVER
Credential	:	LPC
Telephone Number	:	405-668-0147

Provider Enumeration Date	:	03/06/2019
Last Update Date	:	03/06/2019

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Directions to “WINDMILL COUNSELING ” Practice Location

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