MEDICARE: APRIL AJANWACHUKWU 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	6312	OK
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1649631409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APRIL AJANWACHUKWU LCSW

Provider Business Mailing Address
First Line	:	PO BOX 30589
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73140-3589
Country	:	US
Telephone Number	:	405-769-3301
Fax Number	:	405-987-2885

Provider Business Practice Location Address
First Line	:	1309 N NEBRASKA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73117
Country	:	US
Telephone Number	:	405-413-1043
Fax Number	:

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

Provider Enumeration Date	:	03/08/2016
Last Update Date	:	11/13/2018

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