Healthcare Provider Details

I. General information

NPI: 1235753336
Provider Name (Legal Business Name): ASHLEY DAWN SWAIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY SWAIN

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 12TH AVE NE
NORMAN OK
73071-5238
US

IV. Provider business mailing address

908 WILKINSON DR
MOORE OK
73160-6861
US

V. Phone/Fax

Practice location:
  • Phone: 405-573-3819
  • Fax: 405-366-3870
Mailing address:
  • Phone: 405-441-4850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20893
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: