Organization
COMMUNITY NETWORK COUNSELING SERVICE OK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESSENCE BOLDEN (OWENR/MANAGER)
(702) 205-7501
Entity
Organization
Contact information
Practice address
223 E TERRACE AVE, CLINTON, OK 73601-4857
(702) 205-7501
Mailing address
223 E TERRACE AVE, CLINTON, OK 73601-4857
(702) 205-7501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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