Individual provider Active NPI

Melanie Ann McKinley, LCSW, BHCMIII

  • Clinical Social Worker
  • Chickasha, OK
National Provider Identifier
1053559807
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4757 Issued in OK
Practice address
102 E Almar Dr
Chickasha, OK 73018-7327
Phone
(405) 320-0530
NPI assigned
Feb 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4757 OK Primary

Addresses

Primary practice location

102 E Almar Dr
Chickasha, OK 73018-7327

Mailing address

2834 County Street 2791
Chickasha, OK 73018-8144
Phone (405) 320-0530

Other identifiers 1

IdentifierTypeStateIssuer
200415240AMedicaidOK

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053559807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 COUNTY STREET 2791",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730188144",
            "telephone_number": "405-320-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E ALMAR DR",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730187327",
            "telephone_number": "405-320-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW, BHCMIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200415240A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chickasha, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.