| Transformation Therapeutic Counseling Services, Llc | |
|
316 S Hayes Ave Ste D Wagoner OK 74467-5531 | |
| (918) 698-7134 | |
| (918) 485-4317 |
| Full Name | Transformation Therapeutic Counseling Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 316 S Hayes Ave Ste D, Wagoner, Oklahoma |
| Authorized Official Name and Position | Melissa Ann Mcdaris (THERAPIST/OWNER) |
| Authorized Official Contact | 9186987134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformation Therapeutic Counseling Services, Llc 316 S Hayes Ave Ste D Wagoner OK 74467-5531 Ph: (918) 698-7134 | Transformation Therapeutic Counseling Services, Llc 316 S Hayes Ave Ste D Wagoner OK 74467-5531 Ph: (918) 698-7134 |
| NPI Number | 1154839983 |
|---|---|
| Provider Enumeration Date | 01/15/2018 |
| Last Update Date | 01/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154839983 | NPI | - | NPPES |
| 1700915337 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5299 (Oklahoma) | Primary |
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