Mija Self
Individual provider Active NPI Professional Counselor · Lehigh, OK
NPI 1063789709 · NPPES record last updated Aug 30, 2023
Key facts
- NPI
- 1063789709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 7171 (OK)
- Practice address
- 813 N Willow
Lehigh, OK 74523 - Phone
- (580) 378-2920
- NPI assigned
- Nov 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Professional Counselor | 101YP2500X | 7171 | OK | Yes |
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
813 N Willow
Lehigh, OK 74523
Mailing address
PO Box 253
Lehigh, OK 74556-0253
Phone (580) 298-2830
Other providers in Lehigh, OK
All providers in Lehigh, OK · Professional Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.