| Michael Blaine Hough, LCSW, MSW | |
|
705 S Virginia Ave, Bartlesville, OK 74003-4439 | |
| (918) 337-8080 | |
| (918) 337-8099 |
| Full Name | Michael Blaine Hough |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 4 Years |
| Location | 705 S Virginia Ave, Bartlesville, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154812774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 21218 (Oklahoma) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Grand Lake Mental Health Center, Inc. | 4688711534 | 118 |
| 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 |
|---|---|
| Michael Blaine Hough, LCSW, MSW 1604 S Johnstone Ave, Bartlesville, OK 74003-5718 Ph: (918) 330-9493 | Michael Blaine Hough, LCSW, MSW 705 S Virginia Ave, Bartlesville, OK 74003-4439 Ph: (918) 337-8080 |
Brianne Lauren Herron, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 700 S Penn Ave, Bartlesville, OK 74003 Phone: 918-337-8080 | |
Mrs. Carlene Betty Zimmerman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 513 Se Quapaw, Grand Lake Mental Health Center, Bartlesville, OK 74003 Phone: 918-337-8080 Fax: 918-337-8099 | |
Katelyn Abrams, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 700 S Penn Ave, Bartlesville, OK 74003 Phone: 918-337-8080 Fax: 918-337-8099 | |
Kerry T Harlin, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 700 S Penn Ave, Bartlesville, OK 74003 Phone: 918-337-8080 Fax: 918-337-8099 | |
Ms. Alexandra Lies Thorn, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 117 W 5th St, Suite 403, Bartlesville, OK 74003 Phone: 918-336-3626 Fax: 918-336-3626 | |
Kelly Jane Huckleby, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 700 S Penn Ave, Bartlesville, OK 74003 Phone: 844-458-2100 |