Provider Demographics
NPI:1326341306
Name:MTF COUNSELING RESOURCES, LLC
Entity Type:Organization
Organization Name:MTF COUNSELING RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKETING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MANOTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PROMMART
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:918-497-8806
Mailing Address - Street 1:324 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:COWETA
Mailing Address - State:OK
Mailing Address - Zip Code:74429-2532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:324 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-2532
Practice Address - Country:US
Practice Address - Phone:918-279-6565
Practice Address - Fax:918-279-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health