Individual provider Active NPI

Donna Latrice Holden

  • Marriage & Family Therapist
  • Tulsa, OK
National Provider Identifier
1265653083
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
11769 Issued in OK
Practice address
6128 E 38TH St
Tulsa, OK 74135-5832
Phone
(800) 722-3611
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 11769 OK Primary

Addresses

Primary practice location

6128 E 38TH St
Tulsa, OK 74135-5832

Mailing address

6128 E 38TH St
Tulsa, OK 74135-5832
Phone (800) 722-3611

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250311001313 OK Practitioner - Marriage and Family Therapist 4981125671 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11769OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 6, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 6, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

231 E Graham Ave
Pryor, OK 74361

6128 E 38th St
Tulsa, OK 74135
Phone (800) 722-3611

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1265653083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 E 38TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355832",
            "telephone_number": "800-722-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6128 E 38TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355832",
            "telephone_number": "800-722-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "DONNA",
        "middle_name": "LATRICE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "11769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.