Provider Demographics
NPI:1992932743
Name:SPRADLIN, WILLARD (MED LPC)
Entity type:Individual
Prefix:MR
First Name:WILLARD
Middle Name:
Last Name:SPRADLIN
Suffix:
Gender:M
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14853 HIGHWAY 82C
Mailing Address - Street 2:
Mailing Address - City:HULBERT
Mailing Address - State:OK
Mailing Address - Zip Code:74441-3417
Mailing Address - Country:US
Mailing Address - Phone:918-456-0544
Mailing Address - Fax:918-598-3833
Practice Address - Street 1:14853 HIGHWAY 82C
Practice Address - Street 2:
Practice Address - City:HULBERT
Practice Address - State:OK
Practice Address - Zip Code:74441-3417
Practice Address - Country:US
Practice Address - Phone:918-456-0544
Practice Address - Fax:918-598-3833
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health