Joshua Joseph Lange-Casillas

Individual provider Active NPI Professional Counselor · Alva, OK

NPI 1376940650 · NPPES record last updated Dec 2, 2014

Key facts

NPI
1376940650
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
604 Choctaw St
Alva, OK 73717-1626
Phone
(580) 327-1112
NPI assigned
Dec 2, 2014
Sex
Male
Sole proprietor
No

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)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Yes

Addresses

Primary practice location

604 Choctaw St
Alva, OK 73717-1626

Mailing address

604 Choctaw St
Alva, OK 73717-1626
Phone (580) 327-1112

Other providers in Alva, OK

All providers in Alva, OK · Professional Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.