Organization
ADVANCE COUNSELING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT GASTON (PRESIDENT)
(405) 844-8085
Entity
Organization
Contact information
Practice address
6656 NW 39TH EXPY, SUITE 202, BETHANY, OK 73008-2704
(405) 844-8085
(405) 285-1652
Mailing address
1015 WATERWOOD PKWY, SUITE GB2, EDMOND, OK 73034-5327
(405) 844-8085
(405) 285-1652
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
2578
OK
251S00000X
Community/Behavioral Health Agency
Primary
2578
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200020790F
—
OK
Enumeration date
10/04/2012
Last updated
10/04/2012
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