|
| |
|
602 N Broadway St Tecumseh OK 74873-2020 | |
| (405) 585-3833 | |
| (405) 598-6770 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 602 N Broadway St, Tecumseh, Oklahoma |
| Authorized Official Name and Position | Angela Lacynda Phillips (LICENSED PROFESSIOAL COUNSELOR) |
| Authorized Official Contact | 4055853833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 589 Tecumseh OK 74873-0589 Ph: (405) 585-3833 | 602 N Broadway St Tecumseh OK 74873-2020 Ph: (405) 585-3833 |
| NPI Number | 1538657572 |
|---|---|
| Provider Enumeration Date | 04/25/2018 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 3375089964 |
|---|---|
| Medicare Enrollment ID | O20240718004442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538657572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 6747 (Oklahoma) | Primary |
| Provider Name | Angela Lacynda Phillips |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316319510 PECOS PAC ID: 4284170879 Enrollment ID: I20240718004496 |
H2h Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 N Broadway St, Tecumseh, OK 74873 Phone: 405-432-9024 Fax: 405-400-8796 |