Provider Demographics
NPI:1740445808
Name:HAEFEKER, MEREDITH ANNE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:MEREDITH
Middle Name:ANNE
Last Name:HAEFEKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ANNE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 268838
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8838
Mailing Address - Country:US
Mailing Address - Phone:918-619-4400
Mailing Address - Fax:918-619-4601
Practice Address - Street 1:1111 S SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-5440
Practice Address - Country:US
Practice Address - Phone:918-619-4400
Practice Address - Fax:918-619-4601
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK48031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical