Provider Demographics
NPI:1710180310
Name:SUMMERCREST INC.
Entity Type:Organization
Organization Name:SUMMERCREST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA HARBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-686-6876
Mailing Address - Street 1:3300 CHANDLER RD STE 109
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-4909
Mailing Address - Country:US
Mailing Address - Phone:918-686-6876
Mailing Address - Fax:918-686-6826
Practice Address - Street 1:3300 CHANDLER RD STE 109
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-4909
Practice Address - Country:US
Practice Address - Phone:918-686-6876
Practice Address - Fax:918-686-6826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty