Eastern Oklahoma Youth Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EASTERN OKLAHOMA YOUTH SERVICES, INC.

Practice address

511 College CT
Tahlequah, OK 74464-4747

Phone

(918) 453-0600

Fax

(918) 453-0628

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kent Ryan Kelley, LPC

Title

Executive Director

Phone

(918) 420-5325

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1447594502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 S 14TH ST",
            "address_2": "SUITE A20",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745017383",
            "telephone_number": "918-420-5325",
            "fax_number": "918-420-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 COLLEGE CT",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644747",
            "telephone_number": "918-453-0600",
            "fax_number": "918-453-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN OKLAHOMA YOUTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "918-420-5325",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Edwards, LPC-S

• Community/Behavioral Health Agency in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Community/Behavioral Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.