Provider Demographics
NPI:1568054690
Name:REAL LIFE COMMUNICATION TRAINING, LLC
Entity Type:Organization
Organization Name:REAL LIFE COMMUNICATION TRAINING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:RUSSHETTE
Authorized Official - Last Name:RUSHING
Authorized Official - Suffix:
Authorized Official - Credentials:MHR, LPC
Authorized Official - Phone:405-276-2496
Mailing Address - Street 1:3309 SIMMONS DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-1865
Mailing Address - Country:US
Mailing Address - Phone:405-503-1043
Mailing Address - Fax:
Practice Address - Street 1:312 NE 28TH ST STE 109A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-2822
Practice Address - Country:US
Practice Address - Phone:405-276-2496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty