Provider Demographics
NPI:1245395011
Name:GRADY, MARGARET ANN (LPC, LADC, LMT, BCPC)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANN
Last Name:GRADY
Suffix:
Gender:F
Credentials:LPC, LADC, LMT, BCPC
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:GRADY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LADC, LMT, BCPC
Mailing Address - Street 1:5131 N CLASSEN BLVD
Mailing Address - Street 2:STE. 208
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-5258
Mailing Address - Country:US
Mailing Address - Phone:405-896-3808
Mailing Address - Fax:405-242-4105
Practice Address - Street 1:5131 N CLASSEN BLVD
Practice Address - Street 2:STE. 208
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-5258
Practice Address - Country:US
Practice Address - Phone:405-896-3808
Practice Address - Fax:405-242-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0114391101YP2500X
NM0105881101YA0400X
OK4468101YP2500X
OK899101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)