| Cdt Counseling, Llc | |
|
6506 Stone Valley Dr Edmond OK 73034-9558 | |
| (405) 226-5273 | |
| Not Available |
| Full Name | Cdt Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6506 Stone Valley Dr, Edmond, Oklahoma |
| Authorized Official Name and Position | Candace D. Tucker (MEMBER) |
| Authorized Official Contact | 4052265273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cdt Counseling, Llc 6506 Stone Valley Dr Edmond OK 73034-9558 Ph: (405) 226-5273 | Cdt Counseling, Llc 6506 Stone Valley Dr Edmond OK 73034-9558 Ph: (405) 226-5273 |
| NPI Number | 1457791832 |
|---|---|
| Provider Enumeration Date | 06/28/2013 |
| Last Update Date | 06/28/2013 |
| Medicare PECOS PAC ID | 2860832839 |
|---|---|
| Medicare Enrollment ID | O20240425000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457791832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5437 (Oklahoma) | Primary |
| Provider Name | Candace Deanne Tucker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427380443 PECOS PAC ID: 3779923743 Enrollment ID: I20240425000172 |
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