The Jetty Counseling Center

LBN: Jim Wallace & Associates, Inc
The Jetty Counseling Center is an health care organization with primary practice located at 301 W Main St Ste 302 , Ardmore OK 73401-6322. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Jim Wallace & Associates, Inc can be contacted via phone (580) 224-2830, or through Rue-Wallace, Teresa Gale via phone (405) 306-8511.

Contact Information

Primary practice address
301 W Main St Ste 302 Ardmore OK 73401-6322
Phone: (580) 224-2830
Fax: (405) 665-6396
Website:
Map and Directions
Authorized official contact:
Name: Rue-Wallace, Teresa Gale MASTERS SCIENCE
Phone: (405) 306-8511

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1588332613
LBN Legal business name Jim Wallace & Associates, Inc
DBA Doing business as The Jetty Counseling Center
Authorized official Rue-Wallace, Teresa Gale MASTERS SCIENCE
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 2nd, 2021
Last updated Sep 10th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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