Individual provider Active NPI

Eric L. Clements

  • Marriage & Family Therapist
  • Tulsa, OK
National Provider Identifier
1114088895
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
758 Issued in OK
Practice address
6846 S Canton Ave
Suite 501
Tulsa, OK 74136-3412
Phone
(918) 745-0095
Fax
(918) 745-0190
NPI assigned
Dec 13, 2006
Last updated
May 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1673 OK
Marriage & Family Therapist 106H00000X 758 OK Primary

Addresses

Primary practice location

6846 S Canton Ave
Suite 501
Tulsa, OK 74136-3412

Mailing address

6846 S Canton Ave
Suite 501
Tulsa, OK 74136-3412
Phone (918) 745-0095

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

State licenses

LicenseStateTypeSpecialty
758OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Family Institute Inc Professional Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1114088895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6846 S CANTON AVE",
            "address_2": "SUITE 501",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363412",
            "telephone_number": "918-745-0095",
            "fax_number": "918-745-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6846 S CANTON AVE",
            "address_2": "SUITE 501",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363412",
            "telephone_number": "918-745-0095",
            "fax_number": "918-745-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "ERIC",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "1673",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "758",
            "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 May 10, 2011; 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.