NPIMap

Organization Active NPI

Resilient Tribal Roots, PLLC

  • Counseling Psychologist
  • Norman, OK
National Provider Identifier
1265090286
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
RESILIENT TRIBAL ROOTS, PLLC
Practice address
2300 McKown Dr
Norman, OK 73072-6678
Phone
(405) 321-3600
Fax
(405) 321-3612
NPI assigned
Jun 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Dr. Glenna P. Stumblingbear-Riddle, PHDNPI 1649553488
Title
Owner/Psychologist
Phone
(405) 321-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

2300 McKown Dr
Norman, OK 73072-6678

Mailing address

2300 McKown Dr
Norman, OK 73072-6678
Phone (405) 321-3600

Other names 1

  • Resilient Tribal Roots, PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190626002311 OK Part B Supplier - Clinic/Group Practice 1355675307 Receives reassigned benefits from 1 practitioner
Practice locations: Norman, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1265090286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MCKOWN DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730726678",
            "telephone_number": "405-321-3600",
            "fax_number": "405-321-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MCKOWN DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730726678",
            "telephone_number": "405-321-3600",
            "fax_number": "405-321-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT TRIBAL ROOTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-04",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "STUMBLINGBEAR-RIDDLE",
        "authorized_official_first_name": "GLENNA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "405-321-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resilient Tribal Roots, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Resilient Tribal Roots, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.