Provider Demographics
NPI:1649391749
Name:MCCLAIN-GARVIN COUNTY YOUTH & FAMILY CENTER
Entity Type:Organization
Organization Name:MCCLAIN-GARVIN COUNTY YOUTH & FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:MCCLUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MHR, LPC, LMFT, NCC
Authorized Official - Phone:405-527-2424
Mailing Address - Street 1:PO BOX 349
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-0349
Mailing Address - Country:US
Mailing Address - Phone:405-527-2424
Mailing Address - Fax:405-527-6406
Practice Address - Street 1:118 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-5622
Practice Address - Country:US
Practice Address - Phone:405-527-2424
Practice Address - Fax:405-527-6406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty