MEDICARE: MRS. KATHLEEN ARCH 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	3721	OK

General Provider Information

NPI Number	:	1770714966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN ARCH LCSW

Provider Business Mailing Address
First Line	:	2500 MEADOWOOD BLVD
Second Line	:	APT. 208
City	:	NORMAN
State	:	OK
Zip	:	73071-4703
Country	:	US
Telephone Number	:	414-426-3226
Fax Number	:

Provider Business Practice Location Address
First Line	:	3130 S RAINBOW BLVD STE 304
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6212
Country	:	US
Telephone Number	:	702-202-3374
Fax Number	:

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

Provider Enumeration Date	:	08/05/2009
Last Update Date	:	07/21/2022

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