Provider Demographics
NPI:1205287950
Name:AMERICAN COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:AMERICAN COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALICO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-749-6935
Mailing Address - Street 1:4870 S LEWIS AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-5151
Mailing Address - Country:US
Mailing Address - Phone:918-749-6935
Mailing Address - Fax:918-749-7611
Practice Address - Street 1:4870 S LEWIS AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-5151
Practice Address - Country:US
Practice Address - Phone:918-749-6935
Practice Address - Fax:918-749-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1270101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty