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NPI Code Detail

MEDICARE: MS. ANDREA COUSPARIS LCSW

MEDICARE: MS. ANDREA COUSPARIS 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
1104100000XSocial Worker21080OK

General Provider Information

NPI Number : 1740822493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDREA COUSPARIS LCSW
Provider Business Mailing Address
First Line : 2310 W BROADWAY ST
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-2761
Country : US
Telephone Number : 918-682-7210
Fax Number :
Provider Business Practice Location Address
First Line : 2310 W BROADWAY ST
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-2761
Country : US
Telephone Number : 918-682-7210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2019
Last Update Date : 12/10/2025

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Directions to “ MS. ANDREA COUSPARIS LCSW” Practice Location

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