Individual provider Active NPI

Debra Kay Roth, LCSW

  • Marriage & Family Therapist
  • Oklahoma City, OK
National Provider Identifier
1093945552
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
34005274A Issued in IN
Practice address
5350 S Western Ave
305
Oklahoma City, OK 73109-4520
Phone
(405) 632-2949
NPI assigned
Jul 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 34005274A IN Primary

Addresses

Primary practice location

5350 S Western Ave
305
Oklahoma City, OK 73109-4520

Mailing address

5350 S Western Ave
305
Oklahoma City, OK 73109-4520
Phone (405) 632-2949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220910000056 VI Practitioner - Clinical Social Worker 3173907342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34005274AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsy Wagner LLC CurrentSince May 26, 2022 Accepting new patients
Healthy Options for Prevention and Effective Treatment Oklahoma Past Accepting new patients

Locations

5030 Anchor Way
Ste 7
Christiansted, VI 00820
Phone (973) 280-4006

Interoperability endpoints

  • Direct secure messaging: debra.roth.p1@direct.frederikstedhealthvi.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1247961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1093945552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 S WESTERN AVE",
            "address_2": "305",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731094520",
            "telephone_number": "405-632-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 S WESTERN AVE",
            "address_2": "305",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731094520",
            "telephone_number": "405-632-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "DEBRA",
        "middle_name": "KAY",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-19",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "34005274A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.