Organization
ARISE ABOVE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRYL A JACKSON LPC (LPC)
(580) 670-0050
Entity
Organization
Contact information
Practice address
118 S 1ST ST STE A, BLACKWELL, OK 74631-2830
(580) 670-0050
Mailing address
118 S 1ST ST STE A, BLACKWELL, OK 74631-2830
(580) 670-0050
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12744231
CAQH
OK
Enumeration date
01/21/2020
Last updated
02/12/2020
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