Provider Demographics
NPI:1134628902
Name:SGB COUNSELING, LLC
Entity type:Organization
Organization Name:SGB COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARIB
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-563-7088
Mailing Address - Street 1:2608 SADDLEBACK DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5907
Mailing Address - Country:US
Mailing Address - Phone:214-563-7088
Mailing Address - Fax:
Practice Address - Street 1:13909 TECHNOLOGY DR STE A1
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-1060
Practice Address - Country:US
Practice Address - Phone:214-563-7088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty