Active NPI
Catrina Blaise Cantwell
- Mental Health Counselor
- Moore, OK
National Provider Identifier
1447875208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11302
- Practice address
- 620 NW 5TH St Ste D
Moore, OK 73160-3947 - Phone
- (405) 208-4469
- Fax
- (405) 208-4472
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11302 | OK | Primary |
Addresses
Primary practice location
620 NW 5TH St Ste D
Moore, OK 73160-3947
Mailing address
620 NW 5TH St Ste D
Moore, OK 73160-3947
Phone (405) 208-4469
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201133840A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11302 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Therapy Solutions of Oklahoma, LLC | Current | Accepting new patients | |
| Sunbeam Family Services, Inc. | Past | Accepting new patients | |
| Sunbeam Family Services | Past | Accepting new patients |
Locations
620 NW 5th St
Ste D
Moore, OK 73160
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Moore, OK
- NPI 1659855278
-
- Case Management Agency
- Oklahoma City, OK
- NPI 1295179505
-
- Community/Behavioral Health Agency
- Oklahoma City, OK
- NPI 1619015005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1447875208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 NW 5TH ST STE D",
"city": "MOORE",
"state": "OK",
"postal_code": "731603947",
"telephone_number": "405-208-4469",
"fax_number": "405-208-4472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 NW 5TH ST STE D",
"city": "MOORE",
"state": "OK",
"postal_code": "731603947",
"telephone_number": "405-208-4469",
"fax_number": "405-208-4472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTWELL",
"first_name": "CATRINA",
"middle_name": "BLAISE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "11302",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201133840A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.