NPIMap

Organization Active NPI

Pushmataha Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Pryor, OK
National Provider Identifier
1508065970
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
251S00000X Issued in OK
Legal business name
PUSHMATAHA COUNSELING SERVICES, INC.
Practice address
205 S Adair St
Pryor, OK 74361-5201
Phone
(918) 825-4872
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Garry Wayne Russell, LADC, MHR
Title
President/Ceo
Phone
(918) 825-4872

Specialties & licenses 1

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

Addresses

Primary practice location

205 S Adair St
Pryor, OK 74361-5201

Mailing address

205 S Adair St
Pryor, OK 74361-5201
Phone (918) 825-4872

National Provider Directory

National Provider Directory
Tax ID family
Pushmataha Counseling Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

205 S Adair St
Pryor, OK 74361
Phone (918) 803-2779

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1508065970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S ADAIR ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743615201",
            "telephone_number": "918-825-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S ADAIR ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743615201",
            "telephone_number": "918-825-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUSHMATAHA COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "GARRY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "918-825-4872",
        "authorized_official_credential": "LADC, MHR"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "251S00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.