Provider Demographics
NPI:1003168634
Name:MARANDA GREENFIELD, LCSW PLLC
Entity Type:Organization
Organization Name:MARANDA GREENFIELD, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARANDA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-863-1194
Mailing Address - Street 1:1809 OAKMEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-1254
Mailing Address - Country:US
Mailing Address - Phone:405-863-1194
Mailing Address - Fax:
Practice Address - Street 1:1809 OAKMEADOWS DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-1254
Practice Address - Country:US
Practice Address - Phone:405-863-1194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3425251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health