Provider Demographics
NPI:1144842923
Name:FORTH STAR COUNSELING LLC
Entity type:Organization
Organization Name:FORTH STAR COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LAHAB
Authorized Official - Middle Name:BEN
Authorized Official - Last Name:ISRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC-S
Authorized Official - Phone:405-875-2544
Mailing Address - Street 1:5350 S WESTERN AVE STE 734
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-4535
Mailing Address - Country:US
Mailing Address - Phone:405-875-2544
Mailing Address - Fax:800-396-6706
Practice Address - Street 1:5909 NW EXPRESSWAY STE 232
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-4476
Practice Address - Country:US
Practice Address - Phone:405-875-2544
Practice Address - Fax:800-396-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)