Provider Demographics
NPI:1720323934
Name:PROCESS TO PROGRESS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PROCESS TO PROGRESS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:MUKES
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMFT
Authorized Official - Phone:316-990-1907
Mailing Address - Street 1:2101 DEL SIMMONS DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-2411
Mailing Address - Country:US
Mailing Address - Phone:316-990-1907
Mailing Address - Fax:
Practice Address - Street 1:2101 DEL SIMMONS DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-2411
Practice Address - Country:US
Practice Address - Phone:316-990-1907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1041106H00000X
KS1158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200378070AMedicaid