Individual provider Active NPI

Jerica Lyn Dry, LCSW

  • Clinical Social Worker
  • Tulsa, OK
National Provider Identifier
1386086668
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6160 Issued in OK
Practice address
6216 S Lewis Ave Ste 180
Tulsa, OK 74136-1077
Phone
(918) 960-7852
Fax
(539) 664-5738
NPI assigned
Jul 26, 2013
Last updated
May 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6160 OK Primary

Addresses

Primary practice location

6216 S Lewis Ave Ste 180
Tulsa, OK 74136-1077

Mailing address

6216 S Lewis Ave Ste 180
Tulsa, OK 74136-1077
Phone (918) 960-7852

Other practice location 1

2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone (918) 712-4301

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6160OKMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1386086668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6216 S LEWIS AVE STE 180",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361077",
            "telephone_number": "918-960-7852",
            "fax_number": "539-664-5738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6216 S LEWIS AVE STE 180",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361077",
            "telephone_number": "918-960-7852",
            "fax_number": "539-664-5738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2325 S Harvard Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741143300",
            "country_code": "US",
            "telephone_number": "918-712-4301",
            "fax_number": "918-560-1399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRY",
        "first_name": "JERICA",
        "middle_name": "LYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "6160",
            "primary": true
        }
    ],
    "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 May 29, 2020; 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.