Provider Demographics
NPI:1649553876
Name:RURAL AREA COUNSELING
Entity type:Organization
Organization Name:RURAL AREA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:405-275-0867
Mailing Address - Street 1:2508 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3131
Mailing Address - Country:US
Mailing Address - Phone:405-275-2877
Mailing Address - Fax:405-275-2499
Practice Address - Street 1:2508 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-3131
Practice Address - Country:US
Practice Address - Phone:405-275-2877
Practice Address - Fax:405-275-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22144305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization