NPIMap

Organization Active NPI

Southeastern Oklahoma Counseling Services PLLC

  • Community/Behavioral Health Agency
  • Poteau, OK
National Provider Identifier
1386992394
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2430 Issued in OK
Legal business name
SOUTHEASTERN OKLAHOMA COUNSELING SERVICES PLLC
Practice address
205 Dewey Ave
Suite #2
Poteau, OK 74953-4224
Phone
(918) 413-4840
Fax
(918) 649-0404
NPI assigned
Aug 22, 2012
Last updated
Sep 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Patrick Wade Elifritz, MSW LCSW
Title
Therapist/Owner
Phone
(918) 413-4840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2430 OK Primary

Addresses

Primary practice location

205 Dewey Ave
Suite #2
Poteau, OK 74953-4224

Mailing address

301 Joy Dr
Bokoshe, OK 74930-2504
Phone (918) 413-4840

Other identifiers 1

IdentifierTypeStateIssuer
1154526432MedicaidOK

National Provider Directory

National Provider Directory

Locations

205 Dewey Ave
Ste 2
Poteau, OK 74953
Phone (918) 413-4840

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1386992394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 JOY DR",
            "city": "BOKOSHE",
            "state": "OK",
            "postal_code": "749302504",
            "telephone_number": "918-413-4840",
            "fax_number": "918-649-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 DEWEY AVE",
            "address_2": "SUITE #2",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534224",
            "telephone_number": "918-413-4840",
            "fax_number": "918-649-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN OKLAHOMA COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-22",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "ELIFRITZ",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "918-413-4840",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "2430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154526432",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.