Provider Demographics
NPI:1770814162
Name:TOTANI, PENNY (LCSW)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:TOTANI
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 1:931 ARLINGTON ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4055
Mailing Address - Country:US
Mailing Address - Phone:580-332-6851
Mailing Address - Fax:580-310-6047
Practice Address - Street 1:931 ARLINGTON ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4055
Practice Address - Country:US
Practice Address - Phone:580-332-6851
Practice Address - Fax:580-310-6047
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical