Tulsa Family Development Center

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

TULSA FAMILY DEVELOPMENT CENTER

Practice address

4520 S Harvard Ave Ste 200C
Tulsa, OK 74135-2925

Phone

(918) 743-3224

Fax

(918) 743-9623

NPI assigned

Jun 15, 2006

Organization subpart

No

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

Authorized official

Name

Elisa M Woodhead, CMA (AAMA)

Title

Credentialing Manager

Phone

(918) 299-8232

Specialties & licenses 4

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Julie Powell-Thomas, PH.D.

  • Counseling Psychologist
  • Tulsa, OK
  • NPI 1336252972

  Counseling

  NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1376587139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 S HARVARD AVE STE 200C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352925",
            "telephone_number": "918-743-3224",
            "fax_number": "918-743-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 S HARVARD AVE STE 200C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352925",
            "telephone_number": "918-743-3224",
            "fax_number": "918-743-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA FAMILY DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "WOODHEAD",
        "authorized_official_first_name": "ELISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "918-299-8232",
        "authorized_official_credential": "CMA (AAMA)"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "1320",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "411",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tulsa, OK
• Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.