Provider Demographics
NPI:1952611261
Name:FLUCARD SMITH, VICKI MAE (LADC, CBHCM)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:MAE
Last Name:FLUCARD SMITH
Suffix:
Gender:F
Credentials:LADC, CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 67 BOX 5
Mailing Address - Street 2:
Mailing Address - City:CANADIAN
Mailing Address - State:OK
Mailing Address - Zip Code:74425-9700
Mailing Address - Country:US
Mailing Address - Phone:918-339-5800
Mailing Address - Fax:
Practice Address - Street 1:HC 67 BOX 5
Practice Address - Street 2:
Practice Address - City:CANADIAN
Practice Address - State:OK
Practice Address - Zip Code:74425-9700
Practice Address - Country:US
Practice Address - Phone:918-339-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK288101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)