Healthcare Provider Details

I. General information

NPI: 1992828636
Provider Name (Legal Business Name): ANGELA L. ZAYAS, LCSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6666 NW 39TH EXPY
BETHANY OK
73008-2760
US

IV. Provider business mailing address

PO BOX 1729
NORMAN OK
73070-1729
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-3499
  • Fax: 405-364-5379
Mailing address:
  • Phone: 405-321-3499
  • Fax: 405-364-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2951
License Number StateOK

VIII. Authorized Official

Name: ANGELA L ZAYAS
Title or Position: PARTNER
Credential: LCSW
Phone: 405-321-3499