Organization Active NPI

Dragonfly Paths Counseling

  • Clinical Social Worker
  • Yukon, OK
National Provider Identifier
1114500345
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DRAGONFLY PATHS COUNSELING
Practice address
1601 Health Center Pkwy Ste 7
Yukon, OK 73099-6652
Phone
(405) 295-5613
NPI assigned
May 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Authorized official

Name
Cynthia Walden, LCSWNPI 1437497617
Title
Therapist
Phone
(405) 295-5613

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1601 Health Center Pkwy Ste 7
Yukon, OK 73099-6652

Mailing address

701 Holly Ave
Yukon, OK 73099-3803
Phone (405) 830-2203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210930000508 OK Part B Supplier - Clinic/Group Practice 3779980990 Receives reassigned benefits from 1 practitioner
Practice locations: Yukon, OK

National Provider Directory

National Provider Directory

Locations

1601 Health Center Pkwy
Ste 7
Yukon, OK 73099
Phone (405) 295-5613

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": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1114500345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 HOLLY AVE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993803",
            "telephone_number": "405-830-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HEALTH CENTER PKWY STE 7",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996652",
            "telephone_number": "405-295-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAGONFLY PATHS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "WALDEN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "405-295-5613",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.