Provider Demographics
NPI:1811364565
Name:DART, ALISON (LCSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:DART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:DART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:317 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1312
Mailing Address - Country:US
Mailing Address - Phone:405-928-8040
Mailing Address - Fax:405-265-8071
Practice Address - Street 1:317 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1312
Practice Address - Country:US
Practice Address - Phone:405-928-8040
Practice Address - Fax:405-265-8071
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK65951041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical