Active NPI
Amanda Michelle Porras, LMFT-RPT
- Marriage & Family Therapist
- Edmond, OK
National Provider Identifier
1407337892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1396
- Practice address
- 1721 W 33Rd St Ste B
Edmond, OK 73013-3834 - Phone
- (405) 875-5399
- Fax
- (405) 562-3532
- NPI assigned
- Aug 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1396 | OK | Primary |
Addresses
Primary practice location
1721 W 33Rd St Ste B
Edmond, OK 73013-3834
Mailing address
1721 W 33Rd St Ste B
Edmond, OK 73013-3834
Phone (405) 875-5399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 8, 2024 through May 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1407337892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 W 33RD ST STE B",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133834",
"telephone_number": "405-875-5399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 W 33RD ST STE B",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133834",
"telephone_number": "405-875-5399",
"fax_number": "405-562-3532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORRAS",
"first_name": "AMANDA",
"middle_name": "MICHELLE",
"credential": "LMFT-RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-24",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OK",
"license": "1396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.