Organization
ADVANCE COUNSELING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT E GASTON (PRESIDENT)
(405) 844-8085
Entity
Organization
Contact information
Practice address
1015 WATERWOOD PKWY STE G-B2, EDMOND, OK 73034-5355
(405) 844-8085
(405) 285-2186
Mailing address
1900 N MACARTHUR BLVD STE 226, OKLAHOMA CITY, OK 73127-2656
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
2578
OK
251S00000X
Community/Behavioral Health Agency
Primary
2578
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200020790C
—
OK
Enumeration date
01/21/2011
Last updated
01/21/2011
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