| Indigo Bridges Counseling, Pllc | |
|
1541 E 61st St Tulsa OK 74136-0718 | |
| (918) 891-6928 | |
| Not Available |
| Full Name | Indigo Bridges Counseling, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1541 E 61st St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Marilyn A Daniel (OWNER) |
| Authorized Official Contact | 9188916928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indigo Bridges Counseling, Pllc 1541 E 61st St Tulsa OK 74136-0718 Ph: (918) 891-6928 | Indigo Bridges Counseling, Pllc 1541 E 61st St Tulsa OK 74136-0718 Ph: (918) 891-6928 |
| NPI Number | 1124601125 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 02/14/2025 |
| Certification Date | 02/14/2025 |
| Medicare PECOS PAC ID | 1557881828 |
|---|---|
| Medicare Enrollment ID | O20250218001509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124601125 | NPI | - | NPPES |
| 7580 | Other | OK | LPC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Marilyn Mhc Daniel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568001766 PECOS PAC ID: 3375063647 Enrollment ID: I20250218001582 |
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