Organization
BEHAVIORAL HEALTH SERVICES OF GREEN COUNTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LANCE DICKISON LPC (OWNER)
(918) 476-0501
Entity
Organization
Contact information
Practice address
463 SW 579 LOOP BLDG B, CHOUTEAU, OK 74337-2885
(918) 476-0501
Mailing address
463 SW 579 LOOP BLDG B, CHOUTEAU, OK 74337-2885
(918) 476-0501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3005
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200315410A
—
OK
Enumeration date
01/20/2011
Last updated
01/20/2011
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