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General NPI Number Information
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NPI Number | 1225030703
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Entity Type | Individual
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Provider Name | SHIELA KOUGH LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1805 1/2 E 17TH AVE
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City | HUTCHINSON
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State | KS
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Zip | 67501-1102
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Country | US
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Telephone | 405-493-6455
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Fax | 620-532-3710
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Provider Business Mailing Address
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Address Line | 701 CEDAR LAKE BLVD STE 120
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-7815
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Country | US
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Telephone | 405-445-1210
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Fax | 405-445-3310
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4624
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License Number State | KS
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