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Organization

CHILDREN, ADOLESCENT AND FAMILY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEVENIA CAREY LPC (CLINICAL OPERATIONS DIRECTOR)
(918) 429-8184
Entity
Organization

Contact information

Practice address
201 S 5TH ST, MCALESTER, OK 74501-5411
(918) 916-2636
(918) 426-5439
Mailing address
1019 KINKEAD RD, MCALESTER, OK 74501-7704
(918) 429-8184
(918) 426-5439

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200266780C
OK
Enumeration date
11/12/2010
Last updated
10/20/2011
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