| Mirissa Beavers Lcsw Llc | |
|
1011 Texas St Woodward OK 73801-3127 | |
| (580) 205-2035 | |
| (580) 205-2038 |
| Full Name | Mirissa Beavers Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1011 Texas St, Woodward, Oklahoma |
| Authorized Official Name and Position | Mirissa Beavers (OWNER) |
| Authorized Official Contact | 5804980204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mirissa Beavers Lcsw Llc 1011 Texas St Woodward OK 73801-3127 Ph: (580) 205-2035 | Mirissa Beavers Lcsw Llc 1011 Texas St Woodward OK 73801-3127 Ph: (580) 205-2035 |
| NPI Number | 1194655290 |
|---|---|
| Provider Enumeration Date | 05/20/2026 |
| Last Update Date | 05/20/2026 |
| Certification Date | 05/20/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194655290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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