Organization
COAL CREEK COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA RAWLINGS LCSW (INDIVIDUAL AND FAMILY THERAPIST)
(918) 325-1526
Entity
Organization
Contact information
Practice address
204 D ST NE, MIAMI, OK 74354
(918) 325-1526
Mailing address
PO BOX 1633, MIAMI, OK 74355-1633
(918) 325-1526
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5598
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200642610A
—
OK
Enumeration date
05/10/2017
Last updated
05/10/2017
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