Provider Demographics
NPI:1063962215
Name:SHAMROCK COUNSELING SERVICES LLP
Entity type:Organization
Organization Name:SHAMROCK COUNSELING SERVICES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, NCC
Authorized Official - Phone:580-214-0781
Mailing Address - Street 1:718 W BROADWAY AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-3819
Mailing Address - Country:US
Mailing Address - Phone:580-540-2099
Mailing Address - Fax:
Practice Address - Street 1:718 W BROADWAY AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3819
Practice Address - Country:US
Practice Address - Phone:580-540-2099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health