| The Ivy Center, Llc | |
|
15980 Trailhead Rd Mcloud OK 74851-5015 | |
| (405) 827-4666 | |
| (405) 383-4756 |
| Full Name | The Ivy Center, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 15980 Trailhead Rd, Mcloud, Oklahoma |
| Authorized Official Name and Position | Juantia Marshall (OWNER) |
| Authorized Official Contact | 4058274666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Ivy Center, Llc 15980 Trailhead Rd Mcloud OK 74851-5015 Ph: (405) 827-4666 | The Ivy Center, Llc 15980 Trailhead Rd Mcloud OK 74851-5015 Ph: (405) 827-4666 |
| NPI Number | 1205672797 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 07/03/2024 |
| Certification Date | 07/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205672797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Kickapoo Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105365 S.highway 102, Mcloud, OK 74851 Phone: 405-964-2618 | |
Meadow Hazelhoff Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9524 Conners Way, Mcloud, OK 74851 Phone: 405-219-2271 |