Provider Demographics
NPI:1619745809
Name:WALK BESIDE COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:WALK BESIDE COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:FERNOW
Authorized Official - Last Name:TALLENT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:918-864-1811
Mailing Address - Street 1:308-B EAST FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-6507
Mailing Address - Country:US
Mailing Address - Phone:918-200-9690
Mailing Address - Fax:
Practice Address - Street 1:308-B EAST FIRST STREET
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-6507
Practice Address - Country:US
Practice Address - Phone:918-200-9690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty