Provider Demographics
NPI:1598084261
Name:WILLIAMSON, KASEY (BS, CM, BHRS)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:BS, CM, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 W HEFNER RD
Mailing Address - Street 2:APT. 2901
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114
Mailing Address - Country:US
Mailing Address - Phone:405-210-6213
Mailing Address - Fax:
Practice Address - Street 1:1301 W HEFNER RD
Practice Address - Street 2:APT 2901
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-7129
Practice Address - Country:US
Practice Address - Phone:405-210-6213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health