MEDICARE: LACEY HOWELL

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	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	20263	OK

General Provider Information

NPI Number	:	1922533496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACEY HOWELL

Provider Business Mailing Address
First Line	:	1099 S MADISON WOODS
Second Line	:
City	:	CLEVELAND
State	:	OK
Zip	:	74020-7612
Country	:	US
Telephone Number	:	918-402-0868
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 N CLEVELAND AVE
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-7306
Country	:	US
Telephone Number	:	918-402-0868
Fax Number	:

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

Provider Enumeration Date	:	04/21/2017
Last Update Date	:	05/16/2025

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Directions to “ LACEY HOWELL ” Practice Location

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