Provider Demographics
NPI:1962649699
Name:MARGO, K. CRAIG (LPC, LADC, MAC, CCMH)
Entity Type:Individual
Prefix:MR
First Name:K.
Middle Name:CRAIG
Last Name:MARGO
Suffix:
Gender:M
Credentials:LPC, LADC, MAC, CCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 N WESTERN AVE # 225
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7326
Mailing Address - Country:US
Mailing Address - Phone:405-241-9151
Mailing Address - Fax:
Practice Address - Street 1:6608 N WESTERN AVE # 225
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7326
Practice Address - Country:US
Practice Address - Phone:405-241-9151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK40101YA0400X
OK1023101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)