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General NPI Number Information
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NPI Number | 1972139475
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Entity Type | Individual
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Provider Name | LILA RENEE METZKER-KIRKWOOD LPC
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Gender | Female
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Dates
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Enumeration Date | 03/16/2020
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 32300 S. 625 RD.
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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 | 918-786-2930
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Fax | 918-867-5039
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Provider Business Mailing Address
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Address Line | 25402 S. 536 RD.
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City | AFTON
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State | OK
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Zip | 74331-6440
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Country | US
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Telephone | 918-413-8652
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 10533
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License Number State | OK
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Taxonomy #2
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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 #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10533
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License Number State | OK
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