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General NPI Number Information
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NPI Number | 1629567649
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Entity Type | Organization
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Legal Business Name | BRANDON ATKINSON LCSW LLC
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 437 W WILSHIRE BLVD STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7747
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Country | US
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Telephone | 405-456-9760
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 ROBIN RD
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City | EDMOND
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State | OK
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Zip | 73034-6027
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Country | US
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Telephone | 405-456-9760
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | BRANDON ATKINSON
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Credential | LCSW
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Telephone | 405-456-9760
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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 | 4668
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License Number State | OK
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