| Elite Counseling Llc | |
|
413 Highway 70 N Kingston OK 73439-8235 | |
| (580) 564-7308 | |
| (580) 564-7309 |
| Full Name | Elite Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 413 Highway 70 N, Kingston, Oklahoma |
| Authorized Official Name and Position | Melissa D Holt (DIRECTOR) |
| Authorized Official Contact | 5805647308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Counseling Llc 413 Highway 70 N Kingston OK 73439-8235 Ph: (580) 564-7308 | Elite Counseling Llc 413 Highway 70 N Kingston OK 73439-8235 Ph: (580) 564-7308 |
| NPI Number | 1144554585 |
|---|---|
| Provider Enumeration Date | 10/01/2009 |
| Last Update Date | 03/19/2024 |
| Certification Date | 03/19/2024 |
| Medicare PECOS PAC ID | 1759824840 |
|---|---|
| Medicare Enrollment ID | O20240618000269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144554585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Melissa Dee Holt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518190321 PECOS PAC ID: 9931321361 Enrollment ID: I20240618000560 |
| Provider Name | Bobby J Buckaloo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265701411 PECOS PAC ID: 5092259457 Enrollment ID: I20240627000539 |
| Provider Name | Martha Faith Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285046466 PECOS PAC ID: 8729522438 Enrollment ID: I20240704000052 |
| Provider Name | Mollie Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730410515 PECOS PAC ID: 6709320427 Enrollment ID: I20240704000130 |
| Provider Name | Kenneth Warren Norris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366723629 PECOS PAC ID: 6103361654 Enrollment ID: I20240709003794 |
| Provider Name | Robert Glenn White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598084857 PECOS PAC ID: 8325583883 Enrollment ID: I20240709004067 |
| Provider Name | Bryant Thomas Adams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215395520 PECOS PAC ID: 1850836222 Enrollment ID: I20240710000029 |
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 | |
Dana Boldt Green, M.ed., Lpc, Ncgc-2, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8800 Birch St, Kingston, OK 73439 Phone: 580-565-2252 | |
Elite Psychiatric Services 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 | |
Southern Oklahoma Treatment Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 North Hwy 70, Kingston, OK 73439 Phone: 580-564-1660 Fax: 580-564-2475 | |
Balanced Approach Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 Highway 70 N, Kingston, OK 73439 Phone: 405-401-8535 | |
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 |