Individual provider Active NPI

Jayde Elayne Agbo

  • Clinical Social Worker
  • Claremore, OK
National Provider Identifier
1154817542
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21945 Issued in OK
Practice address
3100 Medical Pkwy
Claremore, OK 74017-1088
Phone
(918) 934-8235
NPI assigned
Jul 9, 2018
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21945 OK Primary

Addresses

Primary practice location

3100 Medical Pkwy
Claremore, OK 74017-1088

Mailing address

3100 Medical Pkwy
Claremore, OK 74017-1088
Phone (918) 934-8235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251201002189 OK Practitioner - Clinical Social Worker 4587157367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10617 E 67TH St
Apt 49
Tulsa, OK 74133-2650

114 W Delaware Ave
Nowata, OK 74048-2601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21945OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Nov 19, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Grand Lake Mental Health Center Inc. CurrentSince Nov 19, 2025 Accepting new patients
Family & Children's Services, Inc Past Accepting new patients
Family & Children's Services, Inc Past Accepting new patients

Locations

3100 Medical Pkwy
Claremore, OK 74017
Phone (539) 242-3322

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

1228 Pecan
Pawhuska, OK 74056
Phone (918) 287-3940

Organizations & group practices 5

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": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1154817542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MEDICAL PKWY",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740171088",
            "telephone_number": "918-934-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MEDICAL PKWY",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740171088",
            "telephone_number": "918-934-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBO",
        "first_name": "JAYDE",
        "middle_name": "ELAYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "21945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.