NPIMap

Organization Active NPI

Hartsell Psychological Services, Inc

  • Community/Behavioral Health Agency
  • Tishomingo, OK
National Provider Identifier
1407177306
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
3839 Issued in OK
Legal business name
HARTSELL PSYCHOLOGICAL SERVICES, INC
Practice address
504 E 24TH St
Tishomingo, OK 73460-3214
Phone
(580) 371-9933
Fax
(580) 371-9944
NPI assigned
Jun 15, 2010
Last updated
Jun 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Authorized official

Name
Mrs. Carol Sue Kimbro, MS, LPCNPI 1972806149
Title
Proffesional Coulnsler
Phone
(580) 371-9933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 3839 OK Primary

Addresses

Primary practice location

504 E 24TH St
Tishomingo, OK 73460-3214

Mailing address

504 E 24TH St
Tishoming, OK 73460
Phone (580) 371-9933

Other identifiers 1

IdentifierTypeStateIssuer
100746580EMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
S-Okla Psychological Services Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

504 E 24th St
Tishomingo, OK 73460
Phone (580) 371-9933

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1407177306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E 24TH ST",
            "city": "TISHOMING",
            "state": "OK",
            "postal_code": "73460",
            "telephone_number": "580-371-9933",
            "fax_number": "580-371-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603214",
            "telephone_number": "580-371-9933",
            "fax_number": "580-371-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTSELL PSYCHOLOGICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "KIMBRO",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PROFFESIONAL COULNSLER",
        "authorized_official_telephone_number": "580-371-9933",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "3839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100746580E",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tishomingo, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.