Provider Demographics
NPI:1114246089
Name:MCCAIN, PATRICK
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:MCCAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14330 GARY RD
Mailing Address - Street 2:
Mailing Address - City:MADILL
Mailing Address - State:OK
Mailing Address - Zip Code:73446-8142
Mailing Address - Country:US
Mailing Address - Phone:580-798-7790
Mailing Address - Fax:
Practice Address - Street 1:14330 GARY RD
Practice Address - Street 2:
Practice Address - City:MADILL
Practice Address - State:OK
Practice Address - Zip Code:73446-8142
Practice Address - Country:US
Practice Address - Phone:580-798-7790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5297101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional