Provider Demographics
NPI:1386287944
Name:POOL, KEILAH M (BSW, CM II)
Entity type:Individual
Prefix:
First Name:KEILAH
Middle Name:M
Last Name:POOL
Suffix:
Gender:
Credentials:BSW, CM II
Other - Prefix:
Other - First Name:KEILAH
Other - Middle Name:M
Other - Last Name:WALDROP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:314 S BROADWAY AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-5828
Mailing Address - Country:US
Mailing Address - Phone:580-235-0210
Mailing Address - Fax:
Practice Address - Street 1:314 S BROADWAY AVE STE 14
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-5828
Practice Address - Country:US
Practice Address - Phone:580-235-0210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker