Provider Demographics
NPI:1548757156
Name:KAUSEK, DANA NICOLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:NICOLE
Last Name:KAUSEK
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 1:527 GOTT RD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73705-5103
Mailing Address - Country:US
Mailing Address - Phone:580-213-7937
Mailing Address - Fax:
Practice Address - Street 1:527 GOTT RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73705-5103
Practice Address - Country:US
Practice Address - Phone:580-213-7937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK86421041C0700X, 1041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator