Provider Demographics
NPI:1982935490
Name:KASH, ROY CURTIS (LPC)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:CURTIS
Last Name:KASH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 E EP 2010 ST
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:OK
Mailing Address - Zip Code:74561-1044
Mailing Address - Country:US
Mailing Address - Phone:918-441-9143
Mailing Address - Fax:918-302-0405
Practice Address - Street 1:106 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5300
Practice Address - Country:US
Practice Address - Phone:918-421-8880
Practice Address - Fax:918-302-0405
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4655101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100746580AMedicaid