Glynis Watkins, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3881 Issued in OK

Practice address

205 Main St
Broken Bow, OK 74728-3975

Phone

(580) 584-2478

NPI assigned

Dec 11, 2007

Last updated

Aug 4, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Full Life Family Resource Center LLC

  • Community/Behavioral Health Agency
  • Broken Bow, OK
  • NPI 1215353016
  NPD

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1376726463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MAIN ST",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747283975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAIN ST",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747283975",
            "telephone_number": "580-584-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "GLYNIS",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3881",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17616",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Todd
• Renisa Underwood
• Catherine Valencia, LPC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0117)
• Mitchell Ally Wallis
• Mindi Westbrook
• Erika Ann White, MA
• Jessica Womack
• Linda Mounce Womack, L.P.C.
• Mark Wade Ziegler, DMD

• Professional Counselor in Broken Bow, OK
• Providers in Broken Bow, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.