Provider Demographics
NPI:1649549239
Name:MCNAC, LAKEHSHA K
Entity type:Individual
Prefix:
First Name:LAKEHSHA
Middle Name:K
Last Name:MCNAC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-3819
Mailing Address - Country:US
Mailing Address - Phone:918-360-6446
Mailing Address - Fax:
Practice Address - Street 1:2405 W I 44 SERVICE RD
Practice Address - Street 2:SUITE 113
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8771
Practice Address - Country:US
Practice Address - Phone:405-604-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health