Provider Demographics
NPI:1184961377
Name:SADIE WILLMON-HAQUE, PHD, LCSW, PLLC
Entity type:Organization
Organization Name:SADIE WILLMON-HAQUE, PHD, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SADIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLMON-HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:405-321-3600
Mailing Address - Street 1:2300 MCKOWN DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6678
Mailing Address - Country:US
Mailing Address - Phone:405-321-3600
Mailing Address - Fax:405-321-3612
Practice Address - Street 1:2300 MCKOWN DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6678
Practice Address - Country:US
Practice Address - Phone:405-321-3600
Practice Address - Fax:405-321-3612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2891251S00000X
OK1165251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health