Individual provider Active NPI

Kyann Mitchner

  • Clinical Social Worker
  • Tulsa, OK
National Provider Identifier
1386364685
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21497 Issued in OK
Practice address
650 S Peoria Ave
Tulsa, OK 74120-4429
Phone
(918) 587-9471
Fax
(918) 560-1399
NPI assigned
Aug 29, 2022
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X 21497 OK Primary

Addresses

Primary practice location

650 S Peoria Ave
Tulsa, OK 74120-4429

Mailing address

650 S Peoria Ave
Tulsa, OK 74120-4429
Phone (918) 587-9471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922000650 OK Practitioner - Clinical Social Worker 4688178692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children's Services, Inc CurrentSince Aug 4, 2025 Accepting new patients
Sunbeam Family Services CurrentSince May 19, 2024 Accepting new patients
Sunbeam Family Services, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Flourish Therapies Clinical Current Accepting new patients

Locations

1100 NW 14th St
Oklahoma City, OK 73106
Phone (405) 528-7721

1123 NE Grand Blvd
Oklahoma City, OK 73117
Phone (405) 605-7090

2325 S Harvard Ave
Tulsa, OK 74114
Phone (918) 921-3200

650 S Peoria Ave
Tulsa, OK 74120
Phone (918) 560-1200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1386364685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204429",
            "telephone_number": "918-587-9471",
            "fax_number": "918-560-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204429",
            "telephone_number": "918-587-9471",
            "fax_number": "918-560-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHNER",
        "first_name": "KYANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "21497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.