Provider Demographics
NPI:1255226817
Name:MCCARGO, RENATEE DANIELLE
Entity type:Individual
Prefix:MS
First Name:RENATEE
Middle Name:DANIELLE
Last Name:MCCARGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 HIGHWAY 62
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6728
Mailing Address - Country:US
Mailing Address - Phone:918-758-1910
Mailing Address - Fax:918-300-1400
Practice Address - Street 1:2360 HIGHWAY 62
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6728
Practice Address - Country:US
Practice Address - Phone:918-758-1910
Practice Address - Fax:918-300-1400
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator