Provider Demographics
NPI:1669769527
Name:PROCK, MEAGAN NADEAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:NADEAN
Last Name:PROCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:NADEAN
Other - Last Name:AKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2488 E 81ST ST STE 485
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4265
Mailing Address - Country:US
Mailing Address - Phone:405-365-5840
Mailing Address - Fax:
Practice Address - Street 1:2488 E 81ST ST STE 485
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4265
Practice Address - Country:US
Practice Address - Phone:918-932-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
OK74611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst