Provider Demographics
NPI:1639539927
Name:LEGGETT, CECILIA HERRERA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:HERRERA
Last Name:LEGGETT
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 1:2146 W PINE AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-5434
Mailing Address - Country:US
Mailing Address - Phone:618-528-0342
Mailing Address - Fax:
Practice Address - Street 1:3300 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-5628
Practice Address - Country:US
Practice Address - Phone:405-810-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1045811041C0700X
COCSW.099267181041C0700X
OK61581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical