MEDICARE: DCC, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1902050842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DCC, INC

Provider Business Mailing Address
First Line	:	5272 S LEWIS AVE
Second Line	:	250
City	:	TULSA
State	:	OK
Zip	:	74105-6544
Country	:	US
Telephone Number	:	918-524-3300
Fax Number	:	918-524-3302

Provider Business Practice Location Address
First Line	:	5272 S LEWIS AVE
Second Line	:	250
City	:	TULSA
State	:	OK
Zip	:	74105-6544
Country	:	US
Telephone Number	:	918-524-3300
Fax Number	:	918-524-3302

Authorized Official
Title or Position	:	OWNER
Name	:	DENNIS CAVENAH
Credential	:
Telephone Number	:	918-524-3300

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	12/04/2008

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1578500559 — MR. DENNIS COLBERT CAVENAH M.S.
Practice Location Address:

5272 S LEWIS AVE
TULSA, OK
74105-6544

Practice Phone: 918-524-3300
Practice Fax: 918-524-3302

1386683332 — DR. MARTHA BELL HALLOCK PH.D.
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1386896165 — MARTHA B. HALLOCK PH.D., P.C.
Practice Location Address:

5272 S LEWIS AVE , SUITE 230
TULSA, OK
74105-6544

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1386887982 — LESLIE G SMITH LADC-MH
Practice Location Address:

5272 S LEWIS AVE STE 126
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1457642621 — NDN CONSULTING SERVICES, LLC
Practice Location Address:

5272 S LEWIS AVE , SUITE 220
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1821386079 — MRS. ASHLEY R LEFLORE PH.D.
Practice Location Address:

5272 S LEWIS AVE STE 277
TULSA, OK
74105-6544

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