# SCISSORTAIL COUNSELING SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104435288
- **Authorized official:** SAMANTHA MASQUAT LADC/MH (OWNER)
- **Authorized official phone:** (405) 625-1665

## Contact information

- **Practice address:** 1800 E MEMORIAL RD STE 102, OKLAHOMA CITY, OK 73131-1827
- **Practice address phone:** (405) 625-1665
- **Mailing address:** 3317 MEADOW LN, EDMOND, OK 73013-5420
- **Mailing address phone:** (405) 625-1665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2020
- **Last updated:** 08/04/2020