Healthcare Provider Details

I. General information

NPI: 1174952956
Provider Name (Legal Business Name): MEGAN CIZERLE-BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PENN AVE
BARTLESVILLE OK
74003-3847
US

IV. Provider business mailing address

700 S PENN AVE
BARTLESVILLE OK
74003-3847
US

V. Phone/Fax

Practice location:
  • Phone: 918-337-8080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLAC 1124
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10422
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8409
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: