Active NPI
Michael Dean Fanning, LMFT
- Marriage & Family Therapist
- Sapulpa, OK
National Provider Identifier
1306072756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 950
- Practice address
- 23 E Ross Ave
Sapulpa, OK 74066-6423 - Phone
- (918) 227-2016
- NPI assigned
- May 29, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 950 | OK | Primary |
Addresses
Primary practice location
23 E Ross Ave
Sapulpa, OK 74066-6423
Mailing address
23 E Ross Ave
Sapulpa, OK 74066-6423
Phone (918) 227-2016
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 |
|---|---|---|---|
| 950 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243555200000",
"number": "1306072756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 E ROSS AVE",
"city": "SAPULPA",
"state": "OK",
"postal_code": "740666423",
"telephone_number": "918-227-2016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 E ROSS AVE",
"city": "SAPULPA",
"state": "OK",
"postal_code": "740666423",
"telephone_number": "918-227-2016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNING",
"first_name": "MICHAEL",
"middle_name": "DEAN",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-29",
"last_updated": "2009-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OK",
"license": "950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sapulpa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.