Active NPI
William Henry Mukes Jr., LMFT
- Marriage & Family Therapist
- Edmond, OK
National Provider Identifier
1235469800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1041
- Practice address
- 2500 S Broadway Ste 100
Suite 100
Edmond, OK 73013-4039 - Phone
- (316) 990-1907
- Fax
- (405) 241-5221
- NPI assigned
- Jan 5, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1041 | OK | Primary |
| Marriage & Family Therapist | 106H00000X | 1158 | KS |
Addresses
Primary practice location
2500 S Broadway Ste 100
Suite 100
Edmond, OK 73013-4039
Mailing address
2500 S. Broadway St BLDG 100
Suite 100
Edmond, OK 73013-4038
Phone (316) 990-1907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200378070A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1158 | KS | MD | Clinical Psychologist |
| 1041 | OK | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350518400000",
"number": "1235469800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 S. BROADWAY ST BLDG 100",
"address_2": "SUITE 100",
"city": "EDMOND",
"state": "OK",
"postal_code": "730134038",
"telephone_number": "316-990-1907",
"fax_number": "405-241-5221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 S BROADWAY STE 100",
"address_2": "SUITE 100",
"city": "EDMOND",
"state": "OK",
"postal_code": "730134039",
"telephone_number": "316-990-1907",
"fax_number": "405-241-5221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKES",
"first_name": "WILLIAM",
"middle_name": "HENRY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-05",
"last_updated": "2012-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OK",
"license": "1041",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KS",
"license": "1158",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200378070A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.