| Individual & Family Service Llc | |
|
2840 E 51st St 105 Tulsa OK 74105-1744 | |
| (918) 794-2847 | |
| (918) 747-6601 |
| Full Name | Individual & Family Service Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2840 E 51st St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Cleatta Shumate-johnson (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9187942847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Individual & Family Service Llc 2840 E 51st St 105 Tulsa OK 74105-1744 Ph: (918) 794-2847 | Individual & Family Service Llc 2840 E 51st St 105 Tulsa OK 74105-1744 Ph: (918) 794-2847 |
| NPI Number | 1346650702 |
|---|---|
| Provider Enumeration Date | 05/06/2014 |
| Last Update Date | 05/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346650702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 2503 (Oklahoma) | Primary |
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