Provider Demographics
NPI:1275846339
Name:SMITH-JOHNSON, LAKESSHA (LCSW)
Entity Type:Individual
Prefix:
First Name:LAKESSHA
Middle Name:
Last Name:SMITH-JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAKESSHA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:245 W WILSHIRE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7754
Mailing Address - Country:US
Mailing Address - Phone:405-286-3900
Mailing Address - Fax:405-286-3911
Practice Address - Street 1:245 W WILSHIRE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7754
Practice Address - Country:US
Practice Address - Phone:405-286-3900
Practice Address - Fax:405-286-3911
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK36001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical