Provider Demographics
NPI:1669817888
Name:WHITE, KAELA MICHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAELA
Middle Name:MICHELLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KAELA
Other - Middle Name:MICHELLE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:921 NE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-456-1000
Mailing Address - Fax:
Practice Address - Street 1:2242 NW 39TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8884
Practice Address - Country:US
Practice Address - Phone:405-602-3171
Practice Address - Fax:405-602-3226
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical