Provider Demographics
NPI:1780470898
Name:SMALL TOWN BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:SMALL TOWN BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, RPT
Authorized Official - Phone:405-880-3409
Mailing Address - Street 1:321 S 3RD ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5410
Mailing Address - Country:US
Mailing Address - Phone:918-221-7824
Mailing Address - Fax:
Practice Address - Street 1:321 S 3RD ST STE 4
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5410
Practice Address - Country:US
Practice Address - Phone:918-221-7824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty