Provider Demographics
NPI:1356721203
Name:ANDERSON, MARKIA MAUREEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARKIA
Middle Name:MAUREEN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 AIR DEPOT BLVD
Mailing Address - Street 2:
Mailing Address - City:TINKER AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73145-8716
Mailing Address - Country:US
Mailing Address - Phone:405-582-6576
Mailing Address - Fax:
Practice Address - Street 1:7050 AIR DEPOT BLVD
Practice Address - Street 2:
Practice Address - City:TINKER AFB
Practice Address - State:OK
Practice Address - Zip Code:73145-8716
Practice Address - Country:US
Practice Address - Phone:405-582-6576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA4047104100000X
TX59914104100000X
TX1089901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker