Provider Demographics
NPI:1831854876
Name:SWEAT, LAUREN KINDAL
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KINDAL
Last Name:SWEAT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 W FREDERICKSBURG ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-6135
Mailing Address - Country:US
Mailing Address - Phone:918-946-0098
Mailing Address - Fax:
Practice Address - Street 1:12710 STATE FARM BLVD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-5403
Practice Address - Country:US
Practice Address - Phone:918-986-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL083995214171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator