Healthcare Provider Details

I. General information

NPI: 1912699562
Provider Name (Legal Business Name): CYNTHIA MICHELE LEDFORD LMSW; MSW U/S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 S GEORGE NIGH EXPY
MCALESTER OK
74501-7143
US

IV. Provider business mailing address

13224 SE 202ND RD
TALIHINA OK
74571-5866
US

V. Phone/Fax

Practice location:
  • Phone: 918-423-8440
  • Fax:
Mailing address:
  • Phone: 918-567-2389
  • Fax: 918-567-2417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number20055
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: