Provider Demographics
NPI:1336972272
Name:AT EASE COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:AT EASE COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:RADONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-822-4372
Mailing Address - Street 1:5601 NW 72ND ST STE 234
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5920
Mailing Address - Country:US
Mailing Address - Phone:405-822-4372
Mailing Address - Fax:405-349-4433
Practice Address - Street 1:5601 NW 72ND ST STE 234
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73132-5920
Practice Address - Country:US
Practice Address - Phone:405-822-4372
Practice Address - Fax:405-349-4433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty