Provider Demographics
NPI:1508228297
Name:CARING HEARTS PROFESSIONAL COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:CARING HEARTS PROFESSIONAL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LILY
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LBHP
Authorized Official - Phone:918-644-2888
Mailing Address - Street 1:6390 E 31ST ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5478
Mailing Address - Country:US
Mailing Address - Phone:918-409-9763
Mailing Address - Fax:918-619-9743
Practice Address - Street 1:6390 E 31ST ST
Practice Address - Street 2:SUITE I
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5478
Practice Address - Country:US
Practice Address - Phone:918-409-9763
Practice Address - Fax:918-619-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200504420AMedicaid