Staci Hayes

Individual provider Active NPI Mental Health Counselor · Seminole, OK

NPI 1891076352 · NPPES record last updated Oct 3, 2017

Key facts

NPI
1891076352
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
2010 Boren Blvd
Seminole, OK 74868-2050
Phone
(405) 382-4507
Fax
(405) 382-5269
NPI assigned
Aug 29, 2011
Sex
Female
Sole proprietor
Yes

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
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

2010 Boren Blvd
Seminole, OK 74868-2050

Mailing address

2010 Boren Blvd
Seminole, OK 74868-2050
Phone (405) 382-4507

Other practice location 1

101 N Union Ave
Shawnee, OK 74801-7067
Phone (405) 275-7100

Other providers in Seminole, OK

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

Sources for this page

Verify at the official NPI Registry.