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General NPI Number Information
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NPI Number | 1013243419
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Entity Type | Individual
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Provider Name | GREY MCKELLAR MSW,LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 1027 E 66TH PL
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City | TULSA
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State | OK
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Zip | 74136-3701
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Country | US
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Telephone | 918-492-8200
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Fax | 918-488-0940
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Provider Business Mailing Address
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Address Line | 6262 S SHERIDAN RD
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City | TULSA
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State | OK
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Zip | 74133-4055
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Country | US
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Telephone | 918-492-8200
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Fax | 918-493-3268
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | H2889
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License Number State | OK
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