Derrise L Garner, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1031 Issued in OK

Practice address

2 N Main St Ste 505
Miami, OK 74354-6312

Phone

(877) 540-0202

Fax

(417) 623-0457

NPI assigned

Jun 24, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Herndon Snider & Associates, PC

  • Mental Health Counselor
  • Joplin, MO
  • NPI 1750423984
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1326044397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 E 32ND ST STE 221",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044300",
            "telephone_number": "417-623-1381",
            "fax_number": "417-623-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N MAIN ST STE 505",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546312",
            "telephone_number": "877-540-0202",
            "fax_number": "417-623-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "DERRISE",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200248420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Michael Fuser, P.T.
• Michelle Galan, LPC CANDIDATE
• Rene Galan, M.D.
• Larry Devon Gantt, LCPC
• Vanessa Garcia Arreola
• David Dean Garrett, DPM
• Tara V Garrity, LCSW
• Brianna Garten
• Carol George, MED, LPC-S
• Zaine Alexander Gibson

• All providers in Miami, OK
• Clinical Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.

Verify at the official NPI Registry.