Shawnee Medical Center Clinic, Inc
Organization Active NPI Social Worker · Shawnee, OK
NPI 1205301231 · NPPES record last updated Oct 5, 2018
Key facts
- NPI
- 1205301231
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Social Worker 104100000X
- Legal business name
- SHAWNEE MEDICAL CENTER CLINIC, INC
- Practice address
- 3315 Kethley Rd
Shawnee, OK 74804-9638 - Phone
- (405) 273-5801
- Fax
- (405) 878-3794
- NPI assigned
- Oct 5, 2018
- Organization subpart
- No
Authorized official
- Name
- Crystal L Pena
- Title
- Insurance Credentialing Specialist
- Phone
- (405) 272-7452
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Shawnee Medical Center Clinic Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | Yes |
Addresses
Primary practice location
3315 Kethley Rd
Shawnee, OK 74804-9638
Mailing address
3315 Kethley Rd
Shawnee, OK 74804-9638
Phone (405) 273-5801
Other names
- SSM Health Shawnee Behavorial Health Clinic
Other providers in Shawnee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.