Organization · Type 2 NPI
Prodigy Foundation
Clinical Social Worker · Tahlequah, OK
Practice location
1024 S Muskogee Ave
Tahlequah, OK 74464-4734
Fax (918) 456-8773
Mailing address
PO Box 1247
Tahlequah, OK 74465-1247
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
| Professional Counselor | 101YP2500X | None listed |
| Clinical Social Worker Primary | 1041C0700X | None listed |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
2 other providers at this address
About NPI 1386665743
Prodigy Foundation's National Provider Identifier is 1386665743, issued on Jul 21, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Tahlequah, OK. The record was last updated on Sep 11, 2025.