Provider Demographics
NPI:1851500474
Name:KYGER, CAROLINE SMITHERMAN (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:SMITHERMAN
Last Name:KYGER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 NW 122ND ST
Mailing Address - Street 2:STE. 20
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1957
Mailing Address - Country:US
Mailing Address - Phone:405-242-5305
Mailing Address - Fax:405-242-5345
Practice Address - Street 1:2932 NW 122ND ST
Practice Address - Street 2:STE. 20
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-1957
Practice Address - Country:US
Practice Address - Phone:405-242-5305
Practice Address - Fax:405-242-5345
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK892106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0123456Medicaid