Individual provider Active NPI

Cailey Breanna Mastin, LCSW

  • Clinical Social Worker
  • Moore, OK
National Provider Identifier
1174028948
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20266 Issued in OK
Practice address
620 NW 5TH St Ste D
Moore, OK 73160-3947
Phone
(405) 208-4469
Fax
(405) 208-4472
NPI assigned
Mar 26, 2018
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 20266 OK Primary

Addresses

Primary practice location

620 NW 5TH St Ste D
Moore, OK 73160-3947

Mailing address

221 SW 141St St
Oklahoma City, OK 73170-7249
Phone (918) 916-9609

Other names 1

  • Cailey Breanna Macias Former name

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
I20231013003232 OK Practitioner - Clinical Social Worker 0345695136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Therapy Solutions of Oklahoma, LLCGroup PAC ID 2264808211, 22 clinicians

Practice addresses (Care Compare)

620 NW 5TH St D
Main Office
Moore, OK 73160-3947
Phone (405) 208-4469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20266OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy Solutions of Oklahoma, LLC CurrentSince Aug 28, 2023 Accepting new patients

Locations

620 NW 5th St
Ste D
Moore, OK 73160

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1174028948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 SW 141ST ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731707249",
            "telephone_number": "918-916-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NW 5TH ST STE D",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603947",
            "telephone_number": "405-208-4469",
            "fax_number": "405-208-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTIN",
        "first_name": "CAILEY",
        "middle_name": "BREANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "20266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAILEY",
            "last_name": "MACIAS",
            "middle_name": "BREANNA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.