Gary Fred Blank, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Okmulgee, OK
NPI 1437320249 · NPPES record last updated Mar 19, 2008
Key facts
- NPI
- 1437320249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2249 (OK)
- Practice address
- 323 W 6TH St
Okmulgee, OK 74447-5019 - Phone
- (918) 756-9250
- Fax
- (918) 756-9187
- NPI assigned
- Mar 19, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2249 | OK | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2249 | OK | Yes |
Addresses
Primary practice location
323 W 6TH St
Okmulgee, OK 74447-5019
Mailing address
323 W 6TH St
Okmulgee, OK 74447-5019
Phone (918) 756-9250
Other providers in Okmulgee, OK
- Tamara June Berry
- Lila F. Binning
- Amanda Dawn Bittle
- Brent Matthew Black
- Allison A Blanchard
- Dana Claudia Boone-Price
- Samantha Shawn Bowman
- Joshua E Boyd
- Kristi Boydston
- Benjamin Bradley
All providers in Okmulgee, OK · Clinical Social Worker in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2008. 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.