Organization
BLUE HEAVEN THERAPY, L.L.C.
Active
Other names
Jennifer Cheatham, LPC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L CHEATHAM MSPS, LPC (DIRECTOR)
(405) 220-7165
Entity
Organization
Contact information
Practice address
400 TIMMONS ST., SEMINOLE, OK 74868
(405) 220-7165
(405) 382-2890
Mailing address
1731 LEWIS AVE, SEMINOLE, OK 74868-3615
(405) 220-7165
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200723390B
—
OK
Enumeration date
09/08/2021
Last updated
09/10/2021
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