1104031673 NPI number — MS. B. KAY SMITH M.S.W., L.C.S.W.

Table of content: MS. B. KAY SMITH M.S.W., L.C.S.W. (NPI 1104031673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104031673 NPI number — MS. B. KAY SMITH M.S.W., L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
B.
Provider Middle Name:
KAY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
BOBBIE
Provider Other Middle Name:
KAY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1104031673
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1005 N.W. 38TH STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73118-7117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-830-2286
Provider Business Mailing Address Fax Number:
405-443-3682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 NW EXPRESSWAY STE 860
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73118-1831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-830-1828
Provider Business Practice Location Address Fax Number:
405-443-3682
Provider Enumeration Date:
05/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  3513 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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