Provider Demographics
NPI:1952599318
Name:LIGGETT, STAN LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:STAN
Middle Name:LYNN
Last Name:LIGGETT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7065 SW WESTCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5345
Mailing Address - Country:US
Mailing Address - Phone:580-483-6828
Mailing Address - Fax:
Practice Address - Street 1:3009 WILSON STREET
Practice Address - Street 2:REYNOLDS ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-458-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical