Provider Demographics
NPI:1215798897
Name:WHITE SANDS COUNSELING, LLC
Entity type:Organization
Organization Name:WHITE SANDS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-630-7683
Mailing Address - Street 1:1300 MCGEE DR STE 101A
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5858
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 MCGEE DR STE 101A
Practice Address - Street 2:1300 MCGEE DRIVE, SUITE 101A
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-5858
Practice Address - Country:US
Practice Address - Phone:405-630-7683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)