Oklahoma Kids Psychological Service Center

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

OKLAHOMA KIDS PSYCHOLOGICAL SERVICE CENTER

Practice address

3035 NW 63Rd St Ste 227
Oklahoma City, OK 73116-3631

Phone

(405) 242-6460

Fax

(405) 544-5916

NPI assigned

Oct 4, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Miracle N Goetz, PSY.D.NPI 1083881189

Title

Licensed Clinical Psychologist

Phone

(209) 261-4008

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Miracle Nicole Goetz, PSY. D.

  • Psychologist
  • Oklahoma City, OK
  • NPI 1083881189
  NPD Authorized official

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1194440073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 NW 63RD ST STE 227",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163631",
            "telephone_number": "405-242-6460",
            "fax_number": "405-544-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 NW 63RD ST STE 227",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163631",
            "telephone_number": "405-242-6460",
            "fax_number": "405-544-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA KIDS PSYCHOLOGICAL SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "GOETZ",
        "authorized_official_first_name": "MIRACLE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "209-261-4008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200587910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Oklahoma City, OK
• Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.