Provider Demographics
NPI:1962714659
Name:AFRO/EURO BEHAVIORAL HEALTH (RAYMOND VIRGIL SIMMS)
Entity type:Organization
Organization Name:AFRO/EURO BEHAVIORAL HEALTH (RAYMOND VIRGIL SIMMS)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:VIRGIL
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-829-8289
Mailing Address - Street 1:PO BOX 701944
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74170-1944
Mailing Address - Country:US
Mailing Address - Phone:918-829-8289
Mailing Address - Fax:918-712-8781
Practice Address - Street 1:5646 S BOSTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7725
Practice Address - Country:US
Practice Address - Phone:918-829-8289
Practice Address - Fax:918-712-8781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3589101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty