Active NPI
Ebony Tyler Portis, BHS
- Professional Counselor
- Oklahoma City, OK
National Provider Identifier
1043576192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 101YP2500X
- Practice address
- 1900 NE 36TH St Ste 100G
Oklahoma City, OK 73111-5218 - Phone
- (405) 270-0005
- NPI assigned
- Apr 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 101YP2500X | Primary |
Addresses
Primary practice location
1900 NE 36TH St Ste 100G
Oklahoma City, OK 73111-5218
Mailing address
1900 NE 36TH St Ste 100G
Oklahoma City, OK 73111-5218
Phone (405) 270-0005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333411200000",
"number": "1043576192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 NE 36TH ST STE 100G",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731115218",
"telephone_number": "405-270-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 NE 36TH ST STE 100G",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731115218",
"telephone_number": "405-270-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER PORTIS",
"first_name": "EBONY",
"credential": "BHS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-03",
"last_updated": "2012-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": "101YP2500X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.