Provider Demographics
NPI:1184883811
Name:RURAL AREA COUNSELING CENTER
Entity type:Organization
Organization Name:RURAL AREA COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISHA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:405-379-3505
Mailing Address - Street 1:223 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:HOLDENVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74848-3416
Mailing Address - Country:US
Mailing Address - Phone:405-379-3505
Mailing Address - Fax:405-379-3546
Practice Address - Street 1:223 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-3416
Practice Address - Country:US
Practice Address - Phone:405-379-3505
Practice Address - Fax:405-379-3546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management