Provider Demographics
NPI:1588439178
Name:GREEN COUNTRY EMDR THERAPY PLLC
Entity type:Organization
Organization Name:GREEN COUNTRY EMDR THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-732-9363
Mailing Address - Street 1:1131 E 148TH ST S
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-4407
Mailing Address - Country:US
Mailing Address - Phone:918-732-9363
Mailing Address - Fax:
Practice Address - Street 1:1131 E 148TH ST S
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-4407
Practice Address - Country:US
Practice Address - Phone:918-732-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty