Janet Gayle Willis, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

566 Issued in OK

Practice address

4815 S Harvard Ave
Suite 525
Tulsa, OK 74135-3055

Phone

(918) 619-9060

Fax

(918) 289-0436

NPI assigned

Jul 20, 2006

Last updated

Aug 6, 2015By 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 1

Addresses

Other identifiers 3

Other names 1

• Janet Heath Willis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Janet Willis, PH.D., PLLC

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1073962569
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1053331280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 S HARVARD AVE",
            "address_2": "SUITE 525",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353055",
            "telephone_number": "918-619-9060",
            "fax_number": "918-289-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 S HARVARD AVE",
            "address_2": "SUITE 525",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353055",
            "telephone_number": "918-619-9060",
            "fax_number": "918-289-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JANET",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OK",
            "license": "566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "600522417",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10083921A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100839210B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "WILLIS",
            "middle_name": "HEATH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Tiauna Willis, BA
• David Willis, PTA
• Dickey Ledell Willis
• Ebonye Willis
• Heather Eileen Willis, LCSW
• Lakesha Willis
• Stephanie Alicese Willis
• Tamar L Willis, BS., M.ED.
• Warnetta W Willis
• Yama Yumicka Willis, LPN

• Cognitive & Behavioral Psychologist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Cognitive & Behavioral Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.