Provider Demographics
NPI:1073966834
Name:PEOPLES FAMILY COUNSELING
Entity Type:Organization
Organization Name:PEOPLES FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:N
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-695-2059
Mailing Address - Street 1:9265 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:TALALA
Mailing Address - State:OK
Mailing Address - Zip Code:74080-9588
Mailing Address - Country:US
Mailing Address - Phone:918-695-2059
Mailing Address - Fax:
Practice Address - Street 1:10306 N 138TH EAST AVE STE 206
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4665
Practice Address - Country:US
Practice Address - Phone:918-695-2059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4906101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200391580Medicaid