NPIMap

Organization Active NPI

Enid Counseling & Diagnostic Center, Inc

  • Clinical Psychologist
  • Enid, OK
National Provider Identifier
1124132253
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
821 Issued in OK
Legal business name
ENID COUNSELING & DIAGNOSTIC CENTER, INC
Practice address
230 W Maple Ave
Enid, OK 73701-4012
Phone
(580) 242-5544
Fax
(580) 233-8905
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Dr. Wendi L. Betz, PHD.NPI 1033222120
Title
President
Phone
(580) 242-5544

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 821 OK Primary

Addresses

Primary practice location

230 W Maple Ave
Enid, OK 73701-4012

Mailing address

230 W Maple Ave
Enid, OK 73701-4012
Phone (580) 242-5544

Other identifiers 1

IdentifierTypeStateIssuer
100737550AMedicaidOK

Other names 1

  • Enid Counseling & Diagnostics Center, Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041109001189 OK Part B Supplier - Clinic/Group Practice 7012970106 Receives reassigned benefits from 1 practitioner
Practice locations: Enid, OK

National Provider Directory

National Provider Directory
Tax ID family
Enid Counseling and Diagnostic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1124132253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W MAPLE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014012",
            "telephone_number": "580-242-5544",
            "fax_number": "580-233-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W MAPLE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014012",
            "telephone_number": "580-242-5544",
            "fax_number": "580-233-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENID COUNSELING & DIAGNOSTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "BETZ",
        "authorized_official_first_name": "WENDI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-242-5544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100737550A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enid Counseling & Diagnostics Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.