Provider Demographics
NPI:1093115784
Name:FOUNDATION FAMILY COUNSELING SERVICES RN,PLLC
Entity Type:Organization
Organization Name:FOUNDATION FAMILY COUNSELING SERVICES RN,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINNY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ONUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-606-2528
Mailing Address - Street 1:1900 N. MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA
Mailing Address - State:OK
Mailing Address - Zip Code:73127
Mailing Address - Country:US
Mailing Address - Phone:405-606-2528
Mailing Address - Fax:405-606-2631
Practice Address - Street 1:1900 N MACARTHUR BLVD STE 105
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-2648
Practice Address - Country:US
Practice Address - Phone:405-606-2528
Practice Address - Fax:405-606-2631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK080087766251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1265784920OtherNPPE
OK1265784920OtherNPPES