Provider Demographics
NPI:1053795419
Name:OKEN FURMAN, MELISA (LCSW)
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:
Last Name:OKEN FURMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELISA
Other - Middle Name:
Other - Last Name:OKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1305 CLUB HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:GLADWYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19035-1005
Mailing Address - Country:US
Mailing Address - Phone:516-655-4464
Mailing Address - Fax:
Practice Address - Street 1:1305 CLUB HOUSE RD
Practice Address - Street 2:
Practice Address - City:GLADWYNE
Practice Address - State:PA
Practice Address - Zip Code:19035-1005
Practice Address - Country:US
Practice Address - Phone:516-655-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0201041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty