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Organization

STATE OF OKLAHOMA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUTUMN NICKELSON LADC/LCSW (EXECUTIVE DIRECTOR)
(580) 571-3231
Entity
Organization

Contact information

Practice address
5050 WILLIAMS AVENUE, NORTHWEST CENTER FOR BEHAVIORAL HEALTH, WOODWARD, OK 73801
(580) 256-9700
(580) 256-9704
Mailing address
1222 10TH STREET, SUITE 211, NORTHWEST CENTER FOR BEHAVIORAL HEALTH, WOODWARD, OK 73801-3156
(580) 571-3217
(580) 256-8609

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
11/17/2006
Last updated
03/24/2022
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