Provider Demographics
NPI:1518783083
Name:BACKER COUNSELING
Entity type:Organization
Organization Name:BACKER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:GAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:BACKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-823-5314
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:CRESCENT
Mailing Address - State:OK
Mailing Address - Zip Code:73028-0068
Mailing Address - Country:US
Mailing Address - Phone:405-823-5314
Mailing Address - Fax:405-969-3887
Practice Address - Street 1:106 S GRAND ST
Practice Address - Street 2:
Practice Address - City:CRESCENT
Practice Address - State:OK
Practice Address - Zip Code:73028-0068
Practice Address - Country:US
Practice Address - Phone:405-823-5314
Practice Address - Fax:405-969-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health