Grace Baxter, LMSW-P

Individual provider Active NPI Mental Health Counselor · Altus, OK

NPI 1568028850 · NPPES record last updated Nov 29, 2022

Key facts

NPI
1568028850
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1116 N Main St Ste M12
Altus, OK 73521-3149
Phone
(580) 925-0325
NPI assigned
May 13, 2019
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
CG61115510WAMDCounselor
NA60411306WAMDNurse's Aide

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG61115510 WA
Behavior Technician 106S00000X
Nurse's Aide 376K00000X NA60411306 WA
Student in an Organized Health Care Education/Training Program 390200000X CG61115510 WA
Mental Health Counselor 101YM0800X OK Yes

Addresses

Primary practice location

1116 N Main St Ste M12
Altus, OK 73521-3149

Mailing address

605 Hayes St
Altus, OK 73521-4761
Phone (509) 703-0059

Other names

  • Grace Leeberg Former name

Other providers in Altus, OK

All providers in Altus, OK · Mental Health Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.