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Organization
BEHAVIORAL HEALTH SERVICES OF GREEN COUNTRY
Active
Organization
BEHAVIORAL HEALTH SERVICES OF GREEN COUNTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LANCE DICKISON LPC (OWNER)
(918) 476-0501
Entity
Organization
Contact information
Practice address
463 SW 579 LOOP BLDG B, CHOUTEAU, OK 74337-2885
(918) 476-0501
Mailing address
463 SW 579 LOOP BLDG B, CHOUTEAU, OK 74337-2885
(918) 476-0501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3005
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200315410A
—
OK
Enumeration date
01/20/2011
Last updated
01/20/2011
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