Provider Demographics
NPI:1417415423
Name:PEOPLES FAMILY COUNSELING LLC
Entity Type:Organization
Organization Name:PEOPLES FAMILY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-695-2059
Mailing Address - Street 1:12834 OLD US HWY 169
Mailing Address - Street 2:
Mailing Address - City:OOLOGAH
Mailing Address - State:OK
Mailing Address - Zip Code:74053-0773
Mailing Address - Country:US
Mailing Address - Phone:918-695-2059
Mailing Address - Fax:918-221-7975
Practice Address - Street 1:12834 OLD US 169
Practice Address - Street 2:
Practice Address - City:OOLOGAH
Practice Address - State:OK
Practice Address - Zip Code:74053-7405
Practice Address - Country:US
Practice Address - Phone:918-695-2059
Practice Address - Fax:918-221-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200899340AMedicaid
OK200899340BMedicaid