| Center For Psychological Development, Inc. | |
|
1312 N 1st Ave Durant OK 74701-2810 | |
| (580) 920-2069 | |
| (580) 920-1010 |
| Full Name | Center For Psychological Development, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1312 N 1st Ave, Durant, Oklahoma |
| Authorized Official Name and Position | Stacey L Gibson (CEO/CO-OWNER) |
| Authorized Official Contact | 5809202069 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Psychological Development, Inc. 1312 N 1st Ave Durant OK 74701-2810 Ph: (580) 920-2069 | Center For Psychological Development, Inc. 1312 N 1st Ave Durant OK 74701-2810 Ph: (580) 920-2069 |
| NPI Number | 1831409440 |
|---|---|
| Provider Enumeration Date | 10/15/2010 |
| Last Update Date | 03/20/2024 |
| Certification Date | 03/20/2024 |
| Medicare PECOS PAC ID | 5395929384 |
|---|---|
| Medicare Enrollment ID | O20110415000717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831409440 | NPI | - | NPPES |
| Provider Name | Tiffany D Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417036104 PECOS PAC ID: 5698872380 Enrollment ID: I20070514000510 |
| Provider Name | Steven Doyle Futrell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538236245 PECOS PAC ID: 3870593411 Enrollment ID: I20100430000313 |
| Provider Name | Terrence R Madsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316095961 PECOS PAC ID: 0749630630 Enrollment ID: I20231218004249 |
| Provider Name | Maura Kathleen Cornell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275772246 PECOS PAC ID: 0446601447 Enrollment ID: I20240103003606 |
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