NPIMap

Organization Active NPI

Phobos Behavioral of South Tulsa LLC

  • Behavior Analyst
  • Tulsa, OK
National Provider Identifier
1376311209
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
PHOBOS BEHAVIORAL OF SOUTH TULSA LLC
Practice address
8242 S Harvard Ave Ste a
Tulsa, OK 74137-1648
Phone
(918) 392-3461
Fax
(918) 550-8228
NPI assigned
Dec 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Anthony Tyler Owens, BCBA, NCSP, LBP
Title
Executive Director
Phone
(539) 240-4735

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

8242 S Harvard Ave Ste a
Tulsa, OK 74137-1648

Mailing address

8242 S Harvard Ave Ste a
Tulsa, OK 74137-1648
Phone (918) 392-3461

National Provider Directory

National Provider Directory

Locations

8242 S Harvard Ave
Ste A
Tulsa, OK 74137
Phone (918) 392-3461

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1376311209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8242 S HARVARD AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741371648",
            "telephone_number": "918-392-3461",
            "fax_number": "918-550-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8242 S HARVARD AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741371648",
            "telephone_number": "918-392-3461",
            "fax_number": "918-550-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOBOS BEHAVIORAL OF SOUTH TULSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "539-240-4735",
        "authorized_official_credential": "BCBA, NCSP, LBP"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.