Provider Demographics
NPI:1306876685
Name:SMELA, DONNA D (LCSW)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:D
Last Name:SMELA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-604-3170
Mailing Address - Fax:405-942-4790
Practice Address - Street 1:5100 N BROOKLINE AVE
Practice Address - Street 2:950
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3623
Practice Address - Country:US
Practice Address - Phone:405-604-3170
Practice Address - Fax:405-942-4790
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK04891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKR11093Medicare UPIN