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Organization

COUNSELING ASSOCIATES OF EDMOND, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH JAYNE MOORE LPC (OWNER)
(405) 285-4700
Entity
Organization

Contact information

Practice address
1601 MEDICAL CENTER DR, SUITE 7, EDMOND, OK 73034-6359
(405) 285-4700
(405) 285-4767
Mailing address
1601 MEDICAL CENTER DR, SUITE 7, EDMOND, OK 73034-6359
(405) 285-4700
(405) 285-4767

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2554
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3394233
AETNA
01
5577770
VALUE OPTIONS
01
576339000
MAGELLAN
Enumeration date
09/09/2013
Last updated
09/09/2013
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