Provider Demographics
NPI:1689388852
Name:WHEAT, MADISON LAYNE (LMSW, MSW; U/S)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:LAYNE
Last Name:WHEAT
Suffix:
Gender:F
Credentials:LMSW, MSW; U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8125 S WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-9417
Mailing Address - Country:US
Mailing Address - Phone:405-634-4400
Mailing Address - Fax:
Practice Address - Street 1:8125 S WALKER AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9417
Practice Address - Country:US
Practice Address - Phone:405-634-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor