Provider Demographics
NPI:1861038390
Name:KELSEY, LOGANN WAYNE (LMSW U/S, CMII, BHWC)
Entity type:Individual
Prefix:
First Name:LOGANN
Middle Name:WAYNE
Last Name:KELSEY
Suffix:
Gender:F
Credentials:LMSW U/S, CMII, BHWC
Other - Prefix:
Other - First Name:ALLISYN
Other - Middle Name:LEANNE
Other - Last Name:KELSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 N DENVER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-1816
Mailing Address - Country:US
Mailing Address - Phone:918-582-1200
Mailing Address - Fax:918-581-0777
Practice Address - Street 1:102 N DENVER AVE STE C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-1816
Practice Address - Country:US
Practice Address - Phone:918-582-1200
Practice Address - Fax:918-581-0777
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator