Provider Demographics
NPI:1699854836
Name:OASIS COUNSELING, INC
Entity Type:Organization
Organization Name:OASIS COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRUCATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-943-1851
Mailing Address - Street 1:PO BOX 51247
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-5547
Mailing Address - Country:US
Mailing Address - Phone:270-943-1851
Mailing Address - Fax:
Practice Address - Street 1:1030 SHIVE LN
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-8037
Practice Address - Country:US
Practice Address - Phone:270-943-1851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65940694Medicaid
KY82900150Medicaid
KY82900150Medicaid