Individual provider Active NPI

Patrick J Lavine-Herndon

  • Mental Health Counselor
  • Oklahoma City, OK
National Provider Identifier
1083013742
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4200 Perimeter Center Dr
Suite 245
Oklahoma City, OK 73112-2324
Phone
(405) 606-4424
NPI assigned
Aug 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4200 Perimeter Center Dr
Suite 245
Oklahoma City, OK 73112-2324

Mailing address

4200 Perimeter Center Dr
Suite 245
Oklahoma City, OK 73112-2324
Phone (405) 606-4424

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1083013742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 PERIMETER CENTER DR",
            "address_2": "SUITE 245",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122324",
            "telephone_number": "405-606-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 PERIMETER CENTER DR",
            "address_2": "SUITE 245",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122324",
            "telephone_number": "405-606-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE-HERNDON",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "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 Aug 19, 2014; 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.