MEDICARE: SHIELA KOUGH LMSW

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	4624	KS
2	1041C0700X	Clinical Social Worker	21544	OK

General Provider Information

NPI Number	:	1225030703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIELA KOUGH LMSW

Provider Business Mailing Address
First Line	:	701 CEDAR LAKE BLVD STE 120
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-7815
Country	:	US
Telephone Number	:	405-445-1210
Fax Number	:	405-445-3310

Provider Business Practice Location Address
First Line	:	1805 1/2 E 17TH AVE
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67501-1102
Country	:	US
Telephone Number	:	405-493-6455
Fax Number	:	620-532-3710

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	02/16/2026

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Directions to “ SHIELA KOUGH LMSW” Practice Location

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