Provider Demographics
NPI:1518095629
Name:VALERIA E MILSTEAD-BENABDALLAH LCSW PC
Entity Type:Organization
Organization Name:VALERIA E MILSTEAD-BENABDALLAH LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MILSTEAD-BENABDALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, QCSW, DCSW
Authorized Official - Phone:405-604-0180
Mailing Address - Street 1:1330 N CLASSEN BLVD
Mailing Address - Street 2:307
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6835
Mailing Address - Country:US
Mailing Address - Phone:405-604-0180
Mailing Address - Fax:405-228-0181
Practice Address - Street 1:1330 N CLASSEN BLVD
Practice Address - Street 2:307
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6835
Practice Address - Country:US
Practice Address - Phone:405-604-0180
Practice Address - Fax:405-228-0181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty