Provider Demographics
NPI:1134609563
Name:360 PERIMETER COUNSELING
Entity type:Organization
Organization Name:360 PERIMETER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HELMKA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LADC/MH
Authorized Official - Phone:405-589-8553
Mailing Address - Street 1:3217 N MUELLER AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-4040
Mailing Address - Country:US
Mailing Address - Phone:405-589-8553
Mailing Address - Fax:
Practice Address - Street 1:1741 W 33RD ST STE 100
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3838
Practice Address - Country:US
Practice Address - Phone:405-589-8553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1316101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty