Audrey Katherine Bryan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1696 Issued in OK

Practice address

1620 E 12TH St
Tulsa, OK 74120-5407

Phone

(918) 582-2131

NPI assigned

Nov 12, 2007

Last updated

Nov 12, 2007By 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 1

Addresses

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 Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Parkside, Inc.Group PAC ID 5496644049, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Parkside, Inc.

  • Adult Mental Health Clinic/Center
  • Tulsa, OK
  • NPI 1356552111
  Medicare reassignment Care Compare group NPD
• Parkside, Inc.

  • Psychiatric Hospital
  • Tulsa, OK
  • NPI 1134750649
  NPD
• Parkside, Inc.

  • Psychiatric Hospital
  • Tulsa, OK
  • NPI 1437370772
  NPD

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1235319864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205407",
            "telephone_number": "918-582-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205407",
            "telephone_number": "918-582-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "AUDREY",
        "middle_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "1696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbie Lee Bruton, MD
• Bryan D Archer, DDS, Inc.
• Bryan Lucenta Inc
• Jamie Bryan-Jabbour
• Aaron Bryan, CRNA
• Carolee Bryan
• Dustin Bryan
• John Dearing Bryan, M.D.
• Meredith Bryan
• Reese Kendall Bryan

• Clinical Social Worker in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.