Provider Demographics
NPI:1760723811
Name:ARAGON, JEREMY SCOTT (MSW)
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:SCOTT
Last Name:ARAGON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1054
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-1054
Mailing Address - Country:US
Mailing Address - Phone:918-845-5245
Mailing Address - Fax:
Practice Address - Street 1:24797 S HIGHWAY 66
Practice Address - Street 2:SUITE 5
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74019-2411
Practice Address - Country:US
Practice Address - Phone:918-342-2080
Practice Address - Fax:918-342-0075
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical