MEDICARE: SYDNEY BRIGHT WARREN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2561	OK

General Provider Information

NPI Number	:	1174742779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY BRIGHT WARREN LCSW

Provider Business Mailing Address
First Line	:	PO BOX 54821
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73154-1821
Country	:	US
Telephone Number	:	405-820-1810
Fax Number	:	405-438-3815

Provider Business Practice Location Address
First Line	:	3441 W MEMORIAL RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-7000
Country	:	US
Telephone Number	:	405-820-1810
Fax Number	:	405-438-3815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	12/12/2023

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