Tenaye Hailu, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1096 Issued in OK

Practice address

7633 E 63Rd PL Ste 300
Tulsa, OK 74133-1202

Phone

(918) 740-6195

NPI assigned

Jan 28, 2009

Last updated

Sep 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prof. Tenaye Hailu Baissa Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Mental Health Vitality, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tulsa, OK
  • NPI 1659903409
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1336387315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7633 E 63RD PL STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741331202",
            "telephone_number": "918-740-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7633 E 63RD PL STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741331202",
            "telephone_number": "918-740-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILU",
        "first_name": "TENAYE",
        "name_prefix": "Prof.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-28",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "1096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "1096",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mentalhealthvitality.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7633 E 63rd Pl Ste 300",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741331202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TENAYE",
            "last_name": "BAISSA",
            "middle_name": "HAILU",
            "prefix": "PROF.",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Marriage & Family Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.