Organization
TIBA COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY BRYANT MS (DIRECTOR)
(405) 234-6804
Entity
Organization
Contact information
Practice address
4301 NW 63RD ST STE 305, OKLAHOMA CITY, OK 73116-1504
(405) 234-6804
Mailing address
3801 NW 63RD ST STE 137, OKLAHOMA CITY, OK 73116-1921
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200346790
—
OK
Enumeration date
05/16/2019
Last updated
05/16/2019
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