Provider Demographics
NPI:1598960015
Name:ASSOCIATED THERAPEUTIC SERVICES, PC
Entity Type:Organization
Organization Name:ASSOCIATED THERAPEUTIC SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:KROEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MHR, LPC
Authorized Official - Phone:580-242-4673
Mailing Address - Street 1:1625 W OWEN K GARRIOTT RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5653
Mailing Address - Country:US
Mailing Address - Phone:580-242-4673
Mailing Address - Fax:580-242-4679
Practice Address - Street 1:114 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OK
Practice Address - Zip Code:73759-1232
Practice Address - Country:US
Practice Address - Phone:580-395-3673
Practice Address - Fax:580-242-4679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty