Provider Demographics
NPI:1467790493
Name:MAATI RA COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:MAATI RA COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OP THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCKOY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LADC
Authorized Official - Phone:918-951-5727
Mailing Address - Street 1:6539 E 31ST ST
Mailing Address - Street 2:STE 4B
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1242
Mailing Address - Country:US
Mailing Address - Phone:918-392-4965
Mailing Address - Fax:918-392-4966
Practice Address - Street 1:6539 E 31ST ST
Practice Address - Street 2:STE 4B
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1242
Practice Address - Country:US
Practice Address - Phone:918-392-4965
Practice Address - Fax:918-392-4966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)