37D2187167 CLIA NUMBER - STILLWATER MEDICAL PSYCHIATRY & COUNSELING

Laboratory Demographics

CLIA Number: 37D2187167

Facility Name: STILLWATER MEDICAL PSYCHIATRY & COUNSELING

Facility Address:
406 EAST HALL OF FAME
STILLWATER, OK
ZIP 74075
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Facility Phone Number: 405 533-8612

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740756907

Taxonomy: 106H00000X - Marriage & Family Therapist
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

CLIA Record

Field Name	Field Value
CLIA Number	37D2187167
LAB Type	Physician Office
Facility Name	STILLWATER MEDICAL PSYCHIATRY & COUNSELING
Street	406 EAST HALL OF FAME
City	STILLWATER
State	OK
ZIP	74075
Phone	405 533-8612
CertificateType	4
CertificateEffectiveDate	6/26/2022
CertificateExpirationDate	6/25/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024