NPIMap

Organization Active NPI

Wholistic Therapy LLC

  • Speech-Language Pathologist
  • Guthrie, OK
National Provider Identifier
1457740888
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3775 Issued in OK
Legal business name
WHOLISTIC THERAPY LLC
Practice address
1409 S Division St
Guthrie, OK 73044-5009
Phone
(405) 795-7110
NPI assigned
Jan 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Authorized official

Name
Mrs. Tabetha Nicole Mathiesen, M.S. CCC-SLPNPI 1093065682
Title
Speech-Language Pathologist
Phone
(405) 795-7110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 3775 OK Primary

Addresses

Primary practice location

1409 S Division St
Guthrie, OK 73044-5009

Mailing address

205 E Cimarron Blvd
Crescent, OK 73028-9296
Phone (405) 795-7110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1457740888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E CIMARRON BLVD",
            "city": "CRESCENT",
            "state": "OK",
            "postal_code": "730289296",
            "telephone_number": "405-795-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 S DIVISION ST",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730445009",
            "telephone_number": "405-795-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLISTIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "MATHIESEN",
        "authorized_official_first_name": "TABETHA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "405-795-7110",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.