Thomas Jefferson Pounders III, LCSW, MDIV, PHD

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW 3620 Issued in OK

Practice address

1011 Honor Heights Dr
Mail Code 115
Muskogee, OK 74401-1318

Phone

(918) 577-3000

Fax

(918) 577-3648

NPI assigned

Jul 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Jeff Pounders Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summercrest Inc.

  • Professional Counselor
  • Muskogee, OK
  • NPI 1710180310
  NPD (past)

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1447459482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 W OKMULGEE ST # 328",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014651",
            "telephone_number": "580-320-5287",
            "fax_number": "918-577-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "address_2": "MAIL CODE 115",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-577-3000",
            "fax_number": "918-577-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUNDERS",
        "first_name": "THOMAS",
        "middle_name": "JEFFERSON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "LCSW, MDIV, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "LCSW 3620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE BOARD OF LICENSED SOCIAL WORKERS",
            "identifier": "LCSW 3620",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES",
            "identifier": "CERT CASE MGR 9983",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFF",
            "last_name": "POUNDERS",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew Mark Porter
• Tobi Michelle Poteete
• Janet Maria Potter, LCSW
• Jessica Christina Potter
• David William Potts, M.D.
• Autumn Powell, FNP-C
• David R Powell, M.D.
• Marissa Breanne Powell
• Tina M Powell, LPC
• Practical Podiatry LLC

• Social Worker in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.