Organization
MARSHALL COUNTY COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA LAJEAN MAGNESS MS,LPC, LADC (OWNER/CEO)
(580) 730-0113
Entity
Organization
Contact information
Practice address
300 E WOLF ST, MADILL, OK 73446-2229
(580) 730-0113
(580) 872-4661
Mailing address
300 E WOLF ST, MADILL, OK 73446-2229
(580) 730-0113
(580) 872-4661
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
845
OK
101YP2500X
Professional Counselor
3695
OK
251S00000X
Community/Behavioral Health Agency
Primary
3695
OK
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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