LISA D TIDWELL-MCKAY MS CADC LPC-S NPI 1629375761

NPI Information

NPI: 1629375761
Provider Name: LISA D TIDWELL-MCKAY, MS, CADC, LPC-S
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
19600 E ROSS ST
TAHLEQUAH, OK
ZIP 74464
Phone: (539) 234-3555
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Lisa D Tidwell-mckay, MS, CADC, LPC-S is a mental health counselor in Tahlequah, OK. Lisa D Tidwell-mckay, MS, CADC, LPC-S NPI is 1629375761. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

19600 E ROSS ST
TAHLEQUAH, OK
ZIP 74464-545
Phone: (539) 234-3555
Fax: (539) 234-3501

The NPI 1629375761 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 2/25/2011 and was last updated on 4/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	412	OKLAHOMA	No
2	101YM0800X	Counselor	Mental Health	5739	OKLAHOMA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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