Provider Demographics
NPI:1871601583
Name:NOFZIGER, KAYE MARY CATHERINE (LCSW LMFT)
Entity type:Individual
Prefix:MRS
First Name:KAYE
Middle Name:MARY CATHERINE
Last Name:NOFZIGER
Suffix:
Gender:F
Credentials:LCSW LMFT
Other - Prefix:
Other - First Name:KAYE
Other - Middle Name:MARY CATHERINE
Other - Last Name:SODEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3223 E 31ST STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-2444
Mailing Address - Country:US
Mailing Address - Phone:918-749-6935
Mailing Address - Fax:
Practice Address - Street 1:3223 E 31ST STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-2444
Practice Address - Country:US
Practice Address - Phone:918-749-6935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4221041C0700X
OK566106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R11931Medicare UPIN