Individual provider Active NPI

Vance H. Durham, LMFT

  • Marriage & Family Therapist
  • Lawton, OK
National Provider Identifier
1407190861
Registry record updated Nov 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT # 792 Issued in OK
Practice address
3101 NE Brentwood Dr
Lawton, OK 73507-1909
Phone
(580) 353-0222
NPI assigned
Nov 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT # 792 OK Primary

Addresses

Primary practice location

3101 NE Brentwood Dr
Lawton, OK 73507-1909

Mailing address

3101 NE Brentwood Dr
Lawton, OK 73507-1909
Phone (580) 353-0222

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
I20240220001660 OK Practitioner - Marriage and Family Therapist 6305280132 Practice locations: Lawton, OK

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1815 W Gore Blvd
Lawton, OK 73501-3614
Phone (580) 353-0222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT # 792OKMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1353715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353715200000",
    "number": "1407190861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 NE BRENTWOOD DR",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735071909",
            "telephone_number": "580-353-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 NE BRENTWOOD DR",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735071909",
            "telephone_number": "580-353-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "VANCE",
        "middle_name": "H.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-24",
        "last_updated": "2012-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "LMFT # 792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.