| Advocates For Change Family Services, Pllc | |
|
610 N. Broadway Ave, Shawnee OK 74801-6202 | |
| (405) 615-2447 | |
| (405) 432-5071 |
| Full Name | Advocates For Change Family Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 610 N. Broadway Ave,, Shawnee, Oklahoma |
| Authorized Official Name and Position | Mary Jo Brazier (LCSW, SOLE OWNER) |
| Authorized Official Contact | 4056152447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advocates For Change Family Services, Pllc Po Box 3202 Shawnee OK 74802 Ph: (405) 615-2447 | Advocates For Change Family Services, Pllc 610 N. Broadway Ave, Shawnee OK 74801-6202 Ph: (405) 615-2447 |
| NPI Number | 1740844968 |
|---|---|
| Provider Enumeration Date | 04/23/2019 |
| Last Update Date | 11/24/2023 |
| Medicare PECOS PAC ID | 7416390455 |
|---|---|
| Medicare Enrollment ID | O20240207001306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740844968 | NPI | - | NPPES |
| 200842400A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Mary J Brazier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639478258 PECOS PAC ID: 0446505739 Enrollment ID: I20240207001543 |
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