Provider Demographics
NPI:1245249408
Name:HUNTER, KELVIN H III (LCSW)
Entity type:Individual
Prefix:
First Name:KELVIN
Middle Name:H
Last Name:HUNTER
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 SW 119TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-4505
Mailing Address - Country:US
Mailing Address - Phone:405-759-3880
Mailing Address - Fax:405-759-3882
Practice Address - Street 1:3224 SW 119TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-4505
Practice Address - Country:US
Practice Address - Phone:405-759-3880
Practice Address - Fax:405-759-3882
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical