Provider Demographics
NPI:1457642621
Name:NDN CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:NDN CONSULTING SERVICES, LLC
Other - Org Name:ENGAGE LIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAJICK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVENHAWK
Authorized Official - Suffix:
Authorized Official - Credentials:CHHP, PHD
Authorized Official - Phone:918-712-8882
Mailing Address - Street 1:5272 S LEWIS AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6544
Mailing Address - Country:US
Mailing Address - Phone:918-712-8882
Mailing Address - Fax:888-420-6673
Practice Address - Street 1:5272 S LEWIS AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6544
Practice Address - Country:US
Practice Address - Phone:918-712-8882
Practice Address - Fax:888-420-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health