Provider Demographics
NPI:1467460154
Name:VILE, LEARNARD WILLIAM (LCSW)
Entity Type:Individual
Prefix:
First Name:LEARNARD
Middle Name:WILLIAM
Last Name:VILE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W GRAY ST
Mailing Address - Street 2:SUITE 315
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-7129
Mailing Address - Country:US
Mailing Address - Phone:405-360-1079
Mailing Address - Fax:
Practice Address - Street 1:330 W GRAY ST
Practice Address - Street 2:SUITE 315
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7129
Practice Address - Country:US
Practice Address - Phone:405-360-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical