| Vivacity Counseling, Pllc | |
|
1211 N Shartel Ave Ste 405 Oklahoma City OK 73103-2425 | |
| (405) 977-0505 | |
| Not Available |
| Full Name | Vivacity Counseling, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1211 N Shartel Ave Ste 405, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Marlon Breaux (OWNER/COUNSELOR) |
| Authorized Official Contact | 4053655082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivacity Counseling, Pllc 2013 Nw 22nd St Oklahoma City OK 73106-1617 Ph: (405) 365-5082 | Vivacity Counseling, Pllc 1211 N Shartel Ave Ste 405 Oklahoma City OK 73103-2425 Ph: (405) 977-0505 |
| NPI Number | 1396236477 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 05/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396236477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6363 (Oklahoma) | Primary |
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