Individual & Family Service LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2503 Issued in OK

Legal business name

INDIVIDUAL & FAMILY SERVICE LLC

Practice address

2840 E 51St St
105
Tulsa, OK 74105-1744

Phone

(918) 794-2847

Fax

(918) 747-6601

NPI assigned

May 6, 2014

Organization subpart

No

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

Authorized official

Name

Cleatta Shumate-Johnson, M.ED.

Title

Licensed Professional Counselor

Phone

(918) 794-2847

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Elizabeth Rineer, PH.D.

  • Clinical Psychologist
  • Tulsa, OK
  • NPI 1639256951
  NPD (past)
• Tara Jo Pixley, PH.D.

  • Clinical Psychologist
  • Kansas City, KS
  • NPI 1548785942
  NPD (past)

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1346650702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 E 51ST ST",
            "address_2": "105",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741051744",
            "telephone_number": "918-794-2847",
            "fax_number": "918-747-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 E 51ST ST",
            "address_2": "105",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741051744",
            "telephone_number": "918-794-2847",
            "fax_number": "918-747-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL & FAMILY SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "SHUMATE-JOHNSON",
        "authorized_official_first_name": "CLEATTA",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "918-794-2847",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.