Healthcare Provider Details

I. General information

NPI: 1154574580
Provider Name (Legal Business Name): ERIKA T MILLER LCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 NW EXPRESSWAY STUITE 900
OKLAHOMA CITY OK
73118-1802
US

IV. Provider business mailing address

1900 NW EXPRESSWAY STUITE 900
OKLAHOMA CITY OK
73118-1802
US

V. Phone/Fax

Practice location:
  • Phone: 405-810-1133
  • Fax: 405-810-1155
Mailing address:
  • Phone: 405-810-1133
  • Fax: 405-810-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2300
License Number StateOK

VIII. Authorized Official

Name: ERIKA T MILLER
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 405-810-1133