Provider Demographics
NPI:1548021496
Name:POSITIVELY PSYCHED COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:POSITIVELY PSYCHED COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:405-979-0431
Mailing Address - Street 1:351 N AIR DEPOT BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-1760
Mailing Address - Country:US
Mailing Address - Phone:405-979-0431
Mailing Address - Fax:405-400-2624
Practice Address - Street 1:351 N AIR DEPOT BLVD STE J
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-1760
Practice Address - Country:US
Practice Address - Phone:405-979-0431
Practice Address - Fax:405-400-2624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty