Isaiah Daeshawn Roberson

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

620 NW 5TH St Ste D
Moore, OK 73160-3947

Phone

(405) 208-4469

Fax

(405) 208-4472

NPI assigned

Dec 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Integrated Therapy Solutions of Oklahoma, LLC

  • Community/Behavioral Health Agency
  • Moore, OK
  • NPI 1659855278
  NPD

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1063124246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 NW 5TH ST STE D",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603947",
            "telephone_number": "405-208-4469",
            "fax_number": "405-208-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NW 5TH ST STE D",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603947",
            "telephone_number": "405-208-4469",
            "fax_number": "405-208-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "ISAIAH",
        "middle_name": "DAESHAWN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.itsofok.com",
            "affiliation": "N",
            "endpointDescription": "secure website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.itsofok.com",
            "address_1": "620 NW 5th St Ste D",
            "city": "Moore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731603947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Ricks
• Lauren Riley
• Rindermann P T PLLC
• Crystal Rios, MS, LMFT
• Amber Lynn Roat, BT
• Rebecca Brooke Roberts, MOTR/L
• Billie Robertson, TECH
• Carnell Robinson
• Rebecca Robinson
• Roslyn Robinson

• Counselor in Moore, OK
• Providers in Moore, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.