OrganizationActive
Jim Wallace & Associates Inc
NPI 1164557492 · Community/Behavioral Health Agency · Hugo, OK
Provider details
- NPI number
- 1164557492
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Teresa Rue-Wallace, Ceo(405) 665-4385
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1610 W Jackson St
Hugo, OK 74743-5653
Phone: (405) 665-4385
Fax: (405) 665-6396
Street-level locationGet directions
Mailing address
202 S Washita Ave
Wynnewood, OK 73098-7820
Other names (DBA / former)
- Doing business as
- The Jetty Counseling Center
Registry dates
- Enumerated
- 2007-02-23
- Last updated
- 2025-05-31
- Certified
- 2025-05-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.