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NPI Code Detail

MEDICARE: MS. DALE LORENZEN MCKAY LCSW

MEDICARE: MS. DALE LORENZEN MCKAY 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
11041C0700XClinical Social Worker2920OK

General Provider Information

NPI Number : 1205010485
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DALE LORENZEN MCKAY LCSW
Provider Business Mailing Address
First Line : 6501 NE 50TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73141-9118
Country : US
Telephone Number : 405-605-6111
Fax Number :
Provider Business Practice Location Address
First Line : 6501 NE 50TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73141-9118
Country : US
Telephone Number : 405-605-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2007
Last Update Date : 12/23/2007

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