1. Home
  2. Directory
  3. Oklahoma
  4. Hugo
  5. Community Behavioral Health
  6. NPI Profile

JIM WALLACE & ASSOCIATES INC
NPI 1164557492
Community/Behavioral Health in Hugo, OK

Active since February 23, 2007
1610 W JACKSON ST, HUGO, OK 74743(405) 665-4385(405) 665-6396 Get Directions Write a Review

NPPES record last updated: May 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 31, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Jim Wallace & Associates Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JIM WALLACE & ASSOCIATES INC (NPI 1164557492), doing business as The Jetty Counseling Center, is a healthcare organization registered as a community/behavioral health in Hugo, Oklahoma and active in the NPI registry since February 2007. The organization lists Teresa G Rue-wallace, Ceo, as its authorized official.

NPPES Registry Identity

NPI1164557492
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameJIM WALLACE & ASSOCIATES INC
Location Address1610 W JACKSON STHugo, OK 74743-5653
Mailing Address202 S Washita AveWynnewood, OK 73098-7820 · (405) 665-4385 · Fax (405) 665-6396
Phone(405) 665-4385
Fax(405) 665-6396
Organization SubpartNo
Authorized OfficialTeresa G Rue-wallaceCeo · (405) 665-4385
Enumeration DateFebruary 23, 2007
Last NPPES UpdateMay 31, 20252 updates tracked since enumeration
NPPES CertifiedMay 31, 2025
✔ NPI 1164557492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
1610 W JACKSON ST, Hugo, OK 74743
Open in Google Maps ↗

Other Names 1

Doing Business AsThe Jetty Counseling Center

Other Identifiers 1

Medicaid100749080BOK

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jim Wallace & Associates Inc's NPI number?

The NPI number for Jim Wallace & Associates Inc is 1164557492. It was assigned to this organization in the NPPES registry on February 23, 2007. The provider is doing business as The Jetty Counseling Center.

Where is Jim Wallace & Associates Inc located?

Jim Wallace & Associates Inc is located at 1610 W Jackson St, Hugo, OK 74743. The listed phone number is (405) 665-4385.

What is Jim Wallace & Associates Inc's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Jim Wallace & Associates Inc was last updated on May 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.