Michelle Blank, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2265 Issued in OK

Legal business name

MICHELLE BLANK, LCSW, PLLC

Practice address

501 E 15TH St
500A
Edmond, OK 73013-5043

Phone

(405) 888-5299

NPI assigned

Aug 3, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Blank Blank

Title

President

Phone

(918) 230-9464

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1376097618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E 15TH ST",
            "address_2": "500A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135043",
            "telephone_number": "405-888-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E 15TH ST",
            "address_2": "500A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135043",
            "telephone_number": "405-888-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE BLANK, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "BLANK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-230-9464"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Edmond, OK
• Providers in Edmond, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.