MEDICARE: UKO TYRAWN OKON

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	101YM0800X	Mental Health Counselor	LMSW22888	AZ

General Provider Information

NPI Number	:	1972461150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UKO TYRAWN OKON

Provider Business Mailing Address
First Line	:	6524 N 79TH LN
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85303-3241
Country	:	US
Telephone Number	:	480-274-7441
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 W UNIVERSITY DR STE 5
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85281-7294
Country	:	US
Telephone Number	:	602-670-1031
Fax Number	:

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ UKO TYRAWN OKON ” Practice Location

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