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General NPI Number Information
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NPI Number | 1548344831
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Entity Type | Individual
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Provider Name | SAMUEL A HORTON MSW,LCSW, LMFT
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12 & 12 INC. CENTER FOR ADDICTION TREATMENT 6333 E. SKELLY DRIVE
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City | TULSA
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State | OK
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Zip | 74135
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Country | US
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Telephone | 918-664-4224
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Fax |
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Provider Business Mailing Address
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Address Line | 19732 S HARVARD AVE
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City | MOUNDS
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State | OK
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Zip | 74047-5014
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Country | US
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Telephone | 918-366-8146
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Fax |
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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 | 0814
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License Number State | OK
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