| The Jetty Counseling Center | |
|
301 W Main St Ste 430 Ardmore OK 73401-6322 | |
| (580) 224-2830 | |
| (405) 665-6396 |
| Full Name | The Jetty Counseling Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 301 W Main St Ste 430, Ardmore, Oklahoma |
| Authorized Official Name and Position | Teresa Gale Rue-wallace (OWNER/CEO/PRESIDENT/EXEC. DIRECTOR) |
| Authorized Official Contact | 4053068511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Jetty Counseling Center 202 S Washita Ave Wynnewood OK 73098-7820 Ph: (405) 665-4385 | The Jetty Counseling Center 301 W Main St Ste 430 Ardmore OK 73401-6322 Ph: (580) 224-2830 |
| NPI Number | 1043980188 |
|---|---|
| Provider Enumeration Date | 09/20/2021 |
| Last Update Date | 09/21/2021 |
| Certification Date | 09/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043980188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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› Verified 2 days ago
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