Provider Demographics
NPI:1104334838
Name:LADD, NATHAN (LMSW)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:LADD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 FLEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6551
Mailing Address - Country:US
Mailing Address - Phone:405-740-5227
Mailing Address - Fax:
Practice Address - Street 1:420 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-5601
Practice Address - Country:US
Practice Address - Phone:405-236-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker