Provider Demographics
NPI:1205048311
Name:DORENKAMP, DARNEL DEANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DARNEL
Middle Name:DEANN
Last Name:DORENKAMP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22329 E 1528 RD
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:OK
Mailing Address - Zip Code:73564-5048
Mailing Address - Country:US
Mailing Address - Phone:580-480-0557
Mailing Address - Fax:
Practice Address - Street 1:1307 W GORE BLVD
Practice Address - Street 2:STE B
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3605
Practice Address - Country:US
Practice Address - Phone:580-355-1270
Practice Address - Fax:580-595-4956
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical