Provider Demographics
NPI:1205955226
Name:MULTI-COUNTY YOUTH AND FAMILY SERVICES, INC
Entity type:Organization
Organization Name:MULTI-COUNTY YOUTH AND FAMILY SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEECH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:580-323-3322
Mailing Address - Street 1:600 AVANT AVE
Mailing Address - Street 2:P.O. BOX 104
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-3916
Mailing Address - Country:US
Mailing Address - Phone:580-323-3322
Mailing Address - Fax:580-323-6233
Practice Address - Street 1:600 AVANT AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3916
Practice Address - Country:US
Practice Address - Phone:580-323-3322
Practice Address - Fax:580-323-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100729510CMedicaid
OK20034250AMedicaid
OK200425520AMedicaid