Provider Demographics
NPI:1437452935
Name:SELAH COUNSELING MINISTRIES, LLC
Entity Type:Organization
Organization Name:SELAH COUNSELING MINISTRIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERIDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-820-1611
Mailing Address - Street 1:2500 S BROADWAY STE 300
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4046
Mailing Address - Country:US
Mailing Address - Phone:405-820-1611
Mailing Address - Fax:405-285-9799
Practice Address - Street 1:2500 S BROADWAY STE 300
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4046
Practice Address - Country:US
Practice Address - Phone:405-820-1611
Practice Address - Fax:405-285-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2428251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health