NPI
Jim Wallace and Associates Incorporated
Doing business as The Jetty Counseling Center. Phone (405) 665-4385 · Fax (405) 665-6396 · NPI 1982748067
Read from the NPPES registry on October 24, 2026.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2007-02-20
- Last updated
- 2021-09-08
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Specialties
Licenses
- License OK
- Number not in the file
Location
- Practice location
- 202 S Washita Ave
- City
- Wynnewood OK
- Postal code
- 73098-7820
- Phone
- (405) 665-4385
- Fax
- (405) 665-6396
Organization contact
- Name
- Teresa Rue-Wallace
- Title
- Owner/ CEO/President/Exec. Director
- Phone
- (405) 306-8511
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Wynnewood, OK. 66 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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