| John Vang, | |
|
11312 N 147th East Pl, Owasso, OK 74055-7660 | |
| (559) 289-2520 | |
| Not Available |
| Full Name | John Vang |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 11312 N 147th East Pl, Owasso, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376046391 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8800 (Oklahoma) | Primary |
| Entity Name | Grand Lake Mental Health Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174 |
| Mailing Address | Practice Location Address |
|---|---|
| John Vang, 11312 N 147th East Pl, Owasso, OK 74055-7660 Ph: (559) 289-2520 | John Vang, 11312 N 147th East Pl, Owasso, OK 74055-7660 Ph: (559) 289-2520 |
Jessica Erin Kay, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 10301 N 144th East Ave, Owasso, OK 74055 Phone: 918-261-2768 | |
Cassandra Jackson-smith, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11505 N 132nd East Ave, Owasso, OK 74055 Phone: 918-313-3292 | |
Mrs. Bobbie Diane Lucas, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 12455 E 100th St N Ste 350, Owasso, OK 74055 Phone: 918-274-5510 Fax: 918-403-6312 | |
Mrs. Meredith Lawler, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 10917 N 92nd East Ave, Owasso, OK 74055 Phone: 918-607-9677 |