Provider Demographics
NPI:1104297159
Name:HERITAGE COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:HERITAGE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEXIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BATCHELOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-889-3399
Mailing Address - Street 1:1410 S GIN RD
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-7348
Mailing Address - Country:US
Mailing Address - Phone:580-889-3399
Mailing Address - Fax:580-889-3887
Practice Address - Street 1:1410 S GIN RD
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-7348
Practice Address - Country:US
Practice Address - Phone:580-889-3399
Practice Address - Fax:580-889-3887
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERITAGE COUNSELING SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health