Organization Active NPI

Janet Willis, PH.D., PLLC

  • Community/Behavioral Health Agency
  • Tulsa, OK
National Provider Identifier
1073962569
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
566 Issued in OK
Legal business name
JANET WILLIS, PH.D., PLLC
Practice address
4815 S Harvard Ave
Suite 525
Tulsa, OK 74135-3055
Phone
(918) 619-9060
Fax
(918) 289-0436
NPI assigned
Jun 6, 2016
Last updated
Jun 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Dr. Janet Willis, RN, PH.D.NPI 1053331280
Title
Owner/RN/Psychologist
Phone
(918) 640-2632

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 566 OK Primary

Addresses

Primary practice location

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

Mailing address

4815 S Harvard Ave
Suite 525
Tulsa, OK 74135-3055
Phone (918) 619-9060

Other identifiers 1

IdentifierTypeStateIssuer
10083921AMedicaidOK

National Provider Directory

National Provider Directory

Locations

4815 S Harvard Ave
Ste 525
Tulsa, OK 74135
Phone (918) 619-9060

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1073962569",
    "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": {
        "organization_name": "JANET WILLIS, PH.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OWNER/RN/PSYCHOLOGIST",
        "authorized_official_telephone_number": "918-640-2632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RN, PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10083921A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.