Active NPI
Adolescents and Families at Risk
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tulsa, OK
National Provider Identifier
1104089580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- License
- 1581
- Legal business name
- ADOLESCENTS AND FAMILIES AT RISK
- Practice address
- 9421 E 95TH PL
Tulsa, OK 74133-6166 - Phone
- (918) 402-9858
- NPI assigned
- Jul 7, 2008
- Last updated
- Jul 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mark J Ingram, L.P.C.
- Title
- Cheif Excecutive Officer
- Phone
- (918) 402-9858
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 1581 | OK | Primary |
Addresses
Primary practice location
9421 E 95TH PL
Tulsa, OK 74133-6166
Mailing address
9421 E 95TH PL
Tulsa, OK 74133-6166
Phone (918) 402-9858
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Professional Counselor
- Tulsa, OK
- NPI 1912166364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215388800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215388800000",
"number": "1104089580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9421 E 95TH PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741336166",
"telephone_number": "918-402-9858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9421 E 95TH PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741336166",
"telephone_number": "918-402-9858"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADOLESCENTS AND FAMILIES AT RISK",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-07",
"last_updated": "2008-07-07",
"status": "A",
"authorized_official_last_name": "INGRAM",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CHEIF EXCECUTIVE OFFICER",
"authorized_official_telephone_number": "918-402-9858",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "L.P.C."
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "OK",
"license": "1581",
"primary": true
}
],
"identifiers": [],
"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 Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.