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Organization
IMPACT COUNSELING CENTER LLC
Active
Organization
IMPACT COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHALON MARGARET STOKES LMFT (CHIEF EXECUTIVE DIRECTOR)
(405) 306-0465
Entity
Organization
Contact information
Practice address
115 S MAIN ST, NOBLE, OK 73068-9596
(405) 872-8461
(405) 872-8466
Mailing address
PO BOX 2206, NOBLE, OK 73068-2206
(405) 872-8461
(405) 872-8466
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
955
OK
101YM0800X
Mental Health Counselor
955
OK
101YP2500X
Professional Counselor
955
OK
106H00000X
Marriage & Family Therapist
955
OK
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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