Provider Demographics
NPI:1982287082
Name:MASRI, CARSON SAGE
Entity Type:Individual
Prefix:
First Name:CARSON
Middle Name:SAGE
Last Name:MASRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 S LAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5523
Mailing Address - Country:US
Mailing Address - Phone:918-978-7552
Mailing Address - Fax:
Practice Address - Street 1:6510 S WESTERN AVE STE 400
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1712
Practice Address - Country:US
Practice Address - Phone:405-634-1497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7890104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker