Provider Demographics
NPI:1457535486
Name:CAUGHREAN, AVA HAMILTON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AVA
Middle Name:HAMILTON
Last Name:CAUGHREAN
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 1:6926 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-2742
Mailing Address - Country:US
Mailing Address - Phone:918-744-7224
Mailing Address - Fax:918-744-7240
Practice Address - Street 1:6400 S LEWIS AVE
Practice Address - Street 2:STE 1000
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1088
Practice Address - Country:US
Practice Address - Phone:918-744-7223
Practice Address - Fax:918-744-7240
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical