Irving Baccus Jr., BHRS
Individual provider Active NPI Mental Health Counselor · Midwest City, OK
NPI 1336404292 · NPPES record last updated Jul 6, 2012
Key facts
- NPI
- 1336404292
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 6000 E Reno Ave Apt 1106
Midwest City, OK 73110-2013 - Phone
- (405) 659-5137
- NPI assigned
- Jul 6, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OK | Yes |
Addresses
Primary practice location
6000 E Reno Ave Apt 1106
Midwest City, OK 73110-2013
Mailing address
6000 E Reno Ave Apt 1106
Midwest City, OK 73110-2013
Phone (405) 659-5137
Other providers in Midwest City, OK
- Robin N Avery
- Avinash C. Vyas MD
- Hossein Azartash-Namin
- Patrice Denice Azebbar
- Zaheer U Baber
- Kaegen Baer
- Darcy Baetz
- Bailey Brooks LLC
- Bertjuanette Jorice Bailey-Guthery
- Maurtyna Bailey-Lusby
All providers in Midwest City, OK · Mental Health 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 Jul 6, 2012. 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.