Individual provider Active NPI

Sally A. Jarrell

  • Marriage & Family Therapist
  • Lawton, OK
National Provider Identifier
1366648545
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1290 Issued in OK
Practice address
1815 W Gore Blvd
Lawton, OK 73501-3614
Phone
(580) 512-4107
NPI assigned
Jun 25, 2007
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1290 OK Primary

Addresses

Primary practice location

1815 W Gore Blvd
Lawton, OK 73501-3614

Mailing address

1815 W Gore Blvd
Lawton, OK 73501-3614
Phone (580) 512-4107

Other names 1

  • Sally A. Gossett Former name

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

LicenseStateTypeSpecialty
1290OKMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1366648545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735013614",
            "telephone_number": "580-512-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735013614",
            "telephone_number": "580-512-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "SALLY",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "GOSSETT",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.