Provider Demographics
NPI:1124676424
Name:WECONNECTCOUNSELING
Entity type:Organization
Organization Name:WECONNECTCOUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:918-280-8602
Mailing Address - Street 1:PO BOX 35031
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74153-0031
Mailing Address - Country:US
Mailing Address - Phone:918-280-8602
Mailing Address - Fax:
Practice Address - Street 1:3015 E SKELLY DR STE 313
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6366
Practice Address - Country:US
Practice Address - Phone:918-280-8602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1467716209Medicaid