Provider Demographics
NPI:1336492966
Name:CONNECTIONS COUNSELING AND CONSULTING, PLLC
Entity Type:Organization
Organization Name:CONNECTIONS COUNSELING AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFRREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:918-421-0541
Mailing Address - Street 1:PO BOX 3036
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74502-3036
Mailing Address - Country:US
Mailing Address - Phone:918-421-0541
Mailing Address - Fax:
Practice Address - Street 1:425 E. OSAGE AVENUE
Practice Address - Street 2:ADMINISTRATIVE OFFICE
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501
Practice Address - Country:US
Practice Address - Phone:918-421-0541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health