Provider Demographics
NPI:1720768765
Name:ANDRES, KATELYN (LMSW MSW U/S)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:ANDRES
Suffix:
Gender:F
Credentials:LMSW MSW U/S
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:KRUGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3501 GRASSLAND DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2914
Mailing Address - Country:US
Mailing Address - Phone:405-618-2107
Mailing Address - Fax:
Practice Address - Street 1:1120 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5300
Practice Address - Country:US
Practice Address - Phone:405-360-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK203721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical