Mavis Wyanema Risenhoover, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3198 Issued in OK

Practice address

1407 NE D St
Suite B
Stigler, OK 74462-2815

Phone

(918) 967-8491

Fax

(918) 967-2552

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295807220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E MONROE AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014815",
            "telephone_number": "918-426-7800",
            "fax_number": "918-426-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 NE D ST",
            "address_2": "SUITE B",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622815",
            "telephone_number": "918-967-8491",
            "fax_number": "918-967-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISENHOOVER",
        "first_name": "MAVIS",
        "middle_name": "WYANEMA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Ratliff
• Melissa Reading, BA
• Beth Reese, LMSW
• Emily J Renfrow, LMFT
• Jana Kathleen Reynolds, LMSW-P
• Jeremy D. Roach, O.D.
• Melissa Robbins
• David Lindo Robertson
• Miranda Robinson
• Kelsey Ross

• Clinical Social Worker in Stigler, OK
• Providers in Stigler, 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 Jul 8, 2007; 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.