Organization
IMPACT COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHALON MARGARET STOKES LMFT (CHIEF EXECUTIVE DIRECTOR)
(405) 306-0465
Entity
Organization
Contact information
Practice address
115 S MAIN ST, NOBLE, OK 73068-9596
(405) 872-8461
(405) 872-8466
Mailing address
PO BOX 2206, NOBLE, OK 73068-2206
(405) 872-8461
(405) 872-8466
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
955
OK
101YM0800X
Mental Health Counselor
955
OK
101YP2500X
Professional Counselor
955
OK
106H00000X
Marriage & Family Therapist
955
OK
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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