| Brian Michael Lcsw, Pc | |
|
1300 Mcgee Dr Ste 103 Norman OK 73072-5858 | |
| (405) 606-1500 | |
| Not Available |
| Full Name | Brian Michael Lcsw, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1300 Mcgee Dr Ste 103, Norman, Oklahoma |
| Authorized Official Name and Position | Brian Michael (PRESIDENT) |
| Authorized Official Contact | 4054641051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Michael Lcsw, Pc 307 Horizon View Ct Norman OK 73071-4165 Ph: (405) 464-1051 | Brian Michael Lcsw, Pc 1300 Mcgee Dr Ste 103 Norman OK 73072-5858 Ph: (405) 606-1500 |
| NPI Number | 1225630494 |
|---|---|
| Provider Enumeration Date | 11/12/2020 |
| Last Update Date | 12/23/2020 |
| Certification Date | 12/23/2020 |
| Medicare PECOS PAC ID | 9133531072 |
|---|---|
| Medicare Enrollment ID | O20201217000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225630494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brian Michael |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588262240 PECOS PAC ID: 4486065893 Enrollment ID: I20201116001276 |
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