Sandra L Borne Tustin, LPC

Individual provider Active NPI Professional Counselor · Stigler, OK

NPI 1306086459 · NPPES record last updated Mar 3, 2009

Key facts

NPI
1306086459
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
1505 E Main St
Suite a
Stigler, OK 74462-2804
Phone
(918) 967-4560
Fax
(918) 967-4582
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients
Quest Mhsa Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sandratustin@tdh.allscriptsdirect.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Yes

Addresses

Primary practice location

1505 E Main St
Suite a
Stigler, OK 74462-2804

Mailing address

PO Box 179
Stigler, OK 74462-0179
Phone (918) 967-3368

Other names

  • Sandra L Bourne Former name

Other providers in Stigler, OK

All providers in Stigler, OK · Professional Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.