Mirissa Joy Beavers

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8848 Issued in OK

Practice address

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5104

Phone

(405) 638-0961

NPI assigned

Nov 25, 2019

Last updated

May 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  OK

  Medicare reassignment NPD
• Mirissa Beavers LCSW LLC

  dba Inclusive EMDR and Psychotherapy

  • Clinical Social Worker
  • Woodward, OK
  • NPI 1194655290
  NPD Authorized official
• State of Oklahoma

  • Medical Specialty Clinic/Center
  • Woodward, OK
  • NPI 1750456588
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1013553163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3457 ROBIN DR",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013941",
            "telephone_number": "580-216-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055104",
            "telephone_number": "405-638-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "MIRISSA",
        "middle_name": "JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "8848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Beaver
• Sydney Beaver
• Brook Beavers, M.ED., LPC
• Charles Runnels Beavers, D.D.S.
• Kay Suzette Beavers, D.D.S.
• Erica Stevie Becerra, CPT
• Abel Wayne Beck, B.S.
• Andrea C Beck
• Laura Beck
• Lisa Beck, M.D.

• Clinical Social Worker in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.