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General NPI Number Information
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NPI Number | 1063725315
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Entity Type | Individual
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Provider Name | TINA LOUISE CAUSEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 1115 HAR-BER ROAD
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City | GROVE
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State | OK
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Zip | 74344-7434
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Country | US
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Telephone | 844-458-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 HAR-BER ROAD
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City | GROVE
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State | OK
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Zip | 74344
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Country | US
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Telephone | 844-458-2100
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Fax | 918-273-1843
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4471
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License Number State | OK
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