NPIMap

Organization Active NPI

Distinctive Adolescent and Adult Guidance Counseling Services

  • Community/Behavioral Health Agency
  • Moore, OK
National Provider Identifier
1740517366
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
4096 Issued in OK
Legal business name
DISTINCTIVE ADOLESCENT AND ADULT GUIDANCE COUNSELING SERVICES
Practice address
2119 Riverwalk Dr # 218
Moore, OK 73160-2700
Phone
(405) 812-8623
NPI assigned
Nov 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Authorized official

Name
Deborah A Gray, LPC
Title
Owner
Phone
(405) 812-8623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 4096 OK Primary

Addresses

Primary practice location

2119 Riverwalk Dr # 218
Moore, OK 73160-2700

Mailing address

2119 Riverwalk Dr # 218
Moore, OK 73160-2700
Phone (405) 812-8623

Other identifiers 1

IdentifierTypeStateIssuer
100735950MedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Dag Counseling Servces3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1740517366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 RIVERWALK DR # 218",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602700",
            "telephone_number": "405-812-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 RIVERWALK DR # 218",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602700",
            "telephone_number": "405-812-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE ADOLESCENT AND ADULT GUIDANCE COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-812-8623",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "4096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100735950",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; 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.