Provider Demographics
NPI:1962942045
Name:HOOD, NICOLE ELISIBETH (LMSW-U/S)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ELISIBETH
Last Name:HOOD
Suffix:
Gender:F
Credentials:LMSW-U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-1208
Mailing Address - Country:US
Mailing Address - Phone:508-233-7220
Mailing Address - Fax:
Practice Address - Street 1:605 W. OXFORD ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701
Practice Address - Country:US
Practice Address - Phone:508-233-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5677104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker