Provider Demographics
NPI:1871779231
Name:REAL SOULUTIONS CHRISTIAN COUNSELING, INC
Entity type:Organization
Organization Name:REAL SOULUTIONS CHRISTIAN COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:ALBERTA
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, BCPC
Authorized Official - Phone:918-289-7827
Mailing Address - Street 1:1831 E. 71ST STREET
Mailing Address - Street 2:SUITE 256
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-877-2723
Mailing Address - Fax:
Practice Address - Street 1:1831 E. 71ST STREET
Practice Address - Street 2:SUITE 256
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-877-2723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3030251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health