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General NPI Number Information
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NPI Number | 1962649699
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Entity Type | Individual
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Provider Name | K. CRAIG MARGO LPC, LADC, MAC, CCMH
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Gender | Male
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 11/14/2010
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Provider Practice Location Address
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Address Line | 6608 N WESTERN AVE # 225
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7326
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Country | US
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Telephone | 405-241-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 6608 N WESTERN AVE # 225
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7326
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Country | US
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Telephone | 405-241-9151
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 40
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1023
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License Number State | OK
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