Organization Active NPI

Adolescents and Families at Risk

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tulsa, OK
National Provider Identifier
1104089580
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1581 Issued in OK
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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.NPI 1912166364
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)CodeLicenseStatePrimary
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 Directory

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": "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.

Verify at the official NPI Registry.