Advance Counseling, PC

Organization Active NPI Community/Behavioral Health Agency · Bethany, OK

NPI 1104178904 · NPPES record last updated Oct 4, 2012

Key facts

NPI
1104178904
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
2578 (OK)
Legal business name
ADVANCE COUNSELING, PC
Practice address
6656 NW 39TH Expy
Suite 202
Bethany, OK 73008-2704
Phone
(405) 844-8085
Fax
(405) 285-1652
NPI assigned
Oct 4, 2012
Organization subpart
No

Authorized official

Name
Dwight Gaston
Title
President
Phone
(405) 844-8085

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Advance Counseling PC (8 organizations share this tax ID)

Locations

6656 NW 39th Expy
Ste 202
Bethany, OK 73008
Phone (405) 844-8085

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 2578 OK
Community/Behavioral Health Agency 251S00000X 2578 OK Yes

Addresses

Primary practice location

6656 NW 39TH Expy
Suite 202
Bethany, OK 73008-2704

Mailing address

1015 Waterwood Pkwy
Suite GB2
Edmond, OK 73034-5327
Phone (405) 844-8085

Other identifiers

IdentifierTypeStateIssuer
200020790FMedicaidOK

Other providers in Bethany, OK

All providers in Bethany, OK · Community/Behavioral Health Agency in Oklahoma

Sources for this page

Verify at the official NPI Registry.