Provider Demographics
NPI:1982947453
Name:COMMUNITY COUNSELING AND TESTING SERVICES
Entity Type:Organization
Organization Name:COMMUNITY COUNSELING AND TESTING SERVICES
Other - Org Name:CCTS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC SPSYCH
Authorized Official - Phone:918-932-6444
Mailing Address - Street 1:510 E WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-8428
Mailing Address - Country:US
Mailing Address - Phone:918-923-6444
Mailing Address - Fax:918-923-6051
Practice Address - Street 1:510 E WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-8428
Practice Address - Country:US
Practice Address - Phone:918-923-6444
Practice Address - Fax:918-923-6051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4235251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200325860AMedicaid