Provider Demographics
NPI:1013062751
Name:BETTERLIFE COUNSELING SERVICES INC.,
Entity Type:Organization
Organization Name:BETTERLIFE COUNSELING SERVICES INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:OLORUNNISOMO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC CANDIDATE
Authorized Official - Phone:405-632-0029
Mailing Address - Street 1:6801 S WESTERN AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1817
Mailing Address - Country:US
Mailing Address - Phone:405-632-0029
Mailing Address - Fax:405-632-0057
Practice Address - Street 1:6801 S WESTERN AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1817
Practice Address - Country:US
Practice Address - Phone:405-632-0029
Practice Address - Fax:405-632-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)