Provider Demographics
NPI:1700153129
Name:POSTON, PATTY E (LCSW)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:E
Last Name:POSTON
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 1:6300 EAST BROADWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-6938
Mailing Address - Country:US
Mailing Address - Phone:918-688-9489
Mailing Address - Fax:
Practice Address - Street 1:6300 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-6938
Practice Address - Country:US
Practice Address - Phone:918-688-9489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical