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Organization

NEW LIFE COUNSELING ALLIANCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD S WAGUESPACK JR. BTH, MSW, LCSW (OWNER / PROVIDER)
(580) 500-8050
Entity
Organization

Contact information

Practice address
603 W GARY BLVD, CLINTON, OK 73601-2715
(580) 500-8050
(888) 344-9087
Mailing address
303 N MARKET ST, CORDELL, OK 73632-4229
(580) 500-8050
(888) 344-9087

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201156640-A
OK
Enumeration date
01/11/2023
Last updated
09/12/2025
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