Organization
ADVANCE COUNSELING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT EDWIN GASTON LPC (CEO)
(405) 844-8085
Entity
Organization
Contact information
Practice address
217 W 5TH AVE, SUITE 6, STILLWATER, OK 74074-4056
(405) 844-8085
(405) 285-1652
Mailing address
1732 REDLAND DR, EDMOND, OK 73003-2453
(405) 844-8085
(405) 285-1652
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2578
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200020790H
—
OK
Enumeration date
01/03/2013
Last updated
01/03/2013
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