Provider Demographics
NPI:1902074065
Name:MAXIMUS COUNSELING INC
Entity Type:Organization
Organization Name:MAXIMUS COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTER
Authorized Official - Prefix:MR
Authorized Official - First Name:FEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMADE
Authorized Official - Suffix:
Authorized Official - Credentials:MHR, LADC
Authorized Official - Phone:405-601-1154
Mailing Address - Street 1:5714 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-4515
Mailing Address - Country:US
Mailing Address - Phone:405-601-1154
Mailing Address - Fax:405-601-1183
Practice Address - Street 1:5714 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-4515
Practice Address - Country:US
Practice Address - Phone:405-601-1154
Practice Address - Fax:405-601-1183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health