Individual provider Active NPI

Julia Summers, LCSW

  • Social Worker
  • Pryor, OK
National Provider Identifier
1174153118
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
4070 Issued in OK
Practice address
109 N Fairland St
Pryor, OK 74361-4203
Phone
(918) 825-1405
NPI assigned
Jan 17, 2020
Last updated
Jan 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4070 OK Primary

Addresses

Primary practice location

109 N Fairland St
Pryor, OK 74361-4203

Mailing address

109 N Fairland St
Pryor, OK 74361-4203
Phone (918) 825-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4070OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 3, 2020 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 3, 2020 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

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

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

109 N Fairland St
Pryor, OK 74361
Phone (918) 825-1406

Organizations & group practices 3

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": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1174153118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614203",
            "telephone_number": "918-825-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614203",
            "telephone_number": "918-825-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JULIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "4070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

Verify at the official NPI Registry.