Sonya Lynn Cornwell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1309 Issued in OK

Practice address

310 W Keetoowah St
Tahlequah, OK 74464-3824

Phone

(817) 307-0949

NPI assigned

May 23, 2018

Last updated

Sep 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other names 1

• Dr. Sonya Lynn Gifford-Cornwell Former name

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sonya L Cornwell PHD Clinical Psychologist PLLCGroup PAC ID 8729410048, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Sonya L Cornwell PHD Clinical Psychologist PLLC

  • Clinical Psychologist
  • Tahlequah, OK
  • NPI 1417508904
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1194216374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W KEETOOWAH ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643824",
            "telephone_number": "918-708-9558",
            "fax_number": "918-708-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W KEETOOWAH ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643824",
            "telephone_number": "817-307-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "SONYA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "OK",
            "license": "1309",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OK",
            "license": "1309",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1309",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OK",
            "license": "1309",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "OK",
            "license": "1309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONYA",
            "last_name": "GIFFORD-CORNWELL",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Erica Coward, M.S. LPC CANDIDATE

• Clinical Psychologist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Clinical Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.