| Chickasaw Nation | |
|
12998 Village Rd Kingston OK 73439-5272 | |
| (580) 564-3060 | |
| Not Available |
| Full Name | Chickasaw Nation |
|---|---|
| Speciality | Counselor - Professional |
| Location | 12998 Village Rd, Kingston, Oklahoma |
| Authorized Official Name and Position | Waymon Hinson (EX OFFICER) |
| Authorized Official Contact | 5805596196 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chickasaw Nation 12998 Village Rd Kingston OK 73439-5272 Ph: (580) 564-3060 | Chickasaw Nation 12998 Village Rd Kingston OK 73439-5272 Ph: (580) 564-3060 |
| NPI Number | 1932534880 |
|---|---|
| Provider Enumeration Date | 09/11/2013 |
| Last Update Date | 09/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932534880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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Elite Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 413 Highway 70 N, Kingston, OK 73439 Phone: 580-564-7308 Fax: 580-564-7309 | |
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