Provider Demographics
NPI:1891933438
Name:HEART & SOUL PROFESSIONAL COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:HEART & SOUL PROFESSIONAL COUNSELING SERVICES, INC.
Other - Org Name:ANDRA EPPERLY
Other - Org Type:Other Name
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDRA
Authorized Official - Middle Name:RENAEL
Authorized Official - Last Name:EPPERLY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:580-774-2833
Mailing Address - Street 1:PO BOX 643
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-0643
Mailing Address - Country:US
Mailing Address - Phone:580-774-2833
Mailing Address - Fax:580-774-2803
Practice Address - Street 1:2701 1/2 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-2641
Practice Address - Country:US
Practice Address - Phone:580-774-2833
Practice Address - Fax:580-774-2803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty