Active NPI
Christopher Kelly Young
- Behavior Technician
- Tulsa, OK
National Provider Identifier
1457038713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8242 S Harvard Ave Ste a
Tulsa, OK 74137-1648 - Phone
- (918) 392-3461
- NPI assigned
- Jun 29, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
8242 S Harvard Ave Ste a
Tulsa, OK 74137-1648
Mailing address
1406 S 76TH East Ave
Tulsa, OK 74112-6734
Phone (405) 626-3961
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phobos Behavioral of South Tulsa LLC | Behavior Technician | Current | Accepting new patients |
Locations
8242 S Harvard Ave
Ste A
Tulsa, OK 74137
Phone (918) 392-3461
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1457038713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 S 76TH EAST AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741126734",
"telephone_number": "405-626-3961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8242 S HARVARD AVE STE A",
"city": "TULSA",
"state": "OK",
"postal_code": "741371648",
"telephone_number": "918-392-3461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "CHRISTOPHER",
"middle_name": "KELLY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-29",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.