Provider Demographics
NPI:1255480505
Name:LADD, JENNIFER JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JEAN
Last Name:LADD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8809 ALAMEDA DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-3549
Mailing Address - Country:US
Mailing Address - Phone:405-343-4244
Mailing Address - Fax:
Practice Address - Street 1:932 N FLOOD AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069
Practice Address - Country:US
Practice Address - Phone:405-321-3719
Practice Address - Fax:405-364-3209
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical