Provider Demographics
NPI:1700143096
Name:HARDMAN, ANGELA BONTEMPS (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:BONTEMPS
Last Name:HARDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:GAYLE
Other - Last Name:HARDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:8302 N 101ST EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2365
Mailing Address - Country:US
Mailing Address - Phone:918-272-1556
Mailing Address - Fax:918-272-1556
Practice Address - Street 1:10159 E 11TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-3058
Practice Address - Country:US
Practice Address - Phone:918-237-9508
Practice Address - Fax:918-844-6993
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical