Healthcare Provider Details

I. General information

NPI: 1407100811
Provider Name (Legal Business Name): CASEY A SMITH M.ED., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6608 N WESTERN AVE # 1292
OKLAHOMA CITY OK
73116-7326
US

IV. Provider business mailing address

6608 N WESTERN AVE # 1292
OKLAHOMA CITY OK
73116-7326
US

V. Phone/Fax

Practice location:
  • Phone: 405-252-0650
  • Fax:
Mailing address:
  • Phone: 405-252-0650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0020743
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6802
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: