| Enid Counseling & Diagnostics Center, Inc | |
|
230 W Maple Ave Enid OK 73701-4012 | |
| (580) 242-5544 | |
| (580) 233-8905 |
| Full Name | Enid Counseling & Diagnostics Center, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 230 W Maple Ave, Enid, Oklahoma |
| Authorized Official Name and Position | Wendi L. Betz (PRESIDENT) |
| Authorized Official Contact | 5802425544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enid Counseling & Diagnostics Center, Inc 230 W Maple Ave Enid OK 73701-4012 Ph: (580) 242-5544 | Enid Counseling & Diagnostics Center, Inc 230 W Maple Ave Enid OK 73701-4012 Ph: (580) 242-5544 |
| NPI Number | 1124132253 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 06/01/2011 |
| Medicare PECOS PAC ID | 7012970106 |
|---|---|
| Medicare Enrollment ID | O20041109001189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124132253 | NPI | - | NPPES |
| 100737550A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 821 (Oklahoma) | Primary |
| Provider Name | Wendi L Betz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033222120 PECOS PAC ID: 4880657964 Enrollment ID: I20041109001139 |
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