Individual
MRS. MICHELLE CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC MH
Contact information
Practice address
210 S JT STITES BLVD, SALLISAW, OK 74955-9301
(918) 775-7787
Mailing address
210 S JT STITES BLVD, SALLISAW, OK 74955-9301
(918) 775-7787
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1361
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200383360B
—
OK
Enumeration date
09/29/2011
Last updated
02/14/2024
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