Healthcare Provider Details

I. General information

NPI: 1326514977
Provider Name (Legal Business Name): SHEILA ANN GOOD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 NE 13TH ST
OKLAHOMA CITY OK
73104-5007
US

IV. Provider business mailing address

16071 STATE HIGHWAY 3W
BYARS OK
74831-7367
US

V. Phone/Fax

Practice location:
  • Phone: 405-868-5052
  • Fax: 405-456-1214
Mailing address:
  • Phone: 405-862-8939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number29022
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6104
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: