Dr. Caleb Wayne Lack
Clinical Psychologist
7413 Oak Ave
Edmond
, Oklahoma 73034-9058
Dr. Caleb Wayne Lack
Clinical Psychologist
7413 Oak Ave
Edmond
, Oklahoma 73034-9058
(405) 509-0959
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Caleb Wayne Lack
- 7413 Oak Ave
- Edmond, OK
- Zip : 73034-9058
- Phone : (405) 509-0959
Second Address
- Dr. Caleb Wayne Lack
- 7413 Oak Ave
- Edmond, OK
- Zip : 73034-9058
- Phone : (405) 509-0959
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Is Dr. Caleb Wayne Lack a sole practitioner?
Is Dr. Caleb Wayne Lack accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103G00000X | Clinical Psychologist | 07-37P | AR |
| N | 103TC0700X | Clinical Psychologist | 07-37P | AR |
| Y | 103G00000X | Clinical Psychologist | 1143 | OK |
| Y | 103TC0700X | Clinical Psychologist | 1143 | OK |
National Provider Identifier
| NPI | 1003074741 |
|---|---|
| Provider Name | Dr. Caleb Wayne Lack |
| First Address | Edmond, OK 73034-9058 |
| Second Address | Edmond, OK 73034-9058 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/05/2008 |
| Last Update Date | 21/03/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.