| Betty Jackson Counseling Services | |
|
4528 S Sheridan Rd Ste 117 Tulsa OK 74145-1140 | |
| (918) 794-6570 | |
| (918) 340-5189 |
| Full Name | Betty Jackson Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 4528 S Sheridan Rd Ste 117, Tulsa, Oklahoma |
| Authorized Official Name and Position | Latia R Parker (LIC BEHAVIORAL HEALTH PROFESSIONAL) |
| Authorized Official Contact | 9189025348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Betty Jackson Counseling Services 200 W Hobson Ave Sapulpa OK 74066-3926 Ph: (918) 902-5348 | Betty Jackson Counseling Services 4528 S Sheridan Rd Ste 117 Tulsa OK 74145-1140 Ph: (918) 794-6570 |
| NPI Number | 1508178070 |
|---|---|
| Provider Enumeration Date | 07/13/2010 |
| Last Update Date | 01/10/2012 |
| Medicare PECOS PAC ID | 8123478112 |
|---|---|
| Medicare Enrollment ID | O20240103003082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508178070 | NPI | - | NPPES |
| 200232480A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 659 (Oklahoma) | Secondary |
| 101YP2500X | Counselor - Professional | 3343 (Oklahoma) | Primary |
| Provider Name | Tamika M Sutton-lipsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578850483 PECOS PAC ID: 0244556744 Enrollment ID: I20150227000682 |
| Provider Name | Latia R Parker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164669149 PECOS PAC ID: 0941650931 Enrollment ID: I20240103003266 |
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