Dynamic Psychological & Mediation Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6010 Issued in OK

Legal business name

DYNAMIC PSYCHOLOGICAL & MEDIATION SERVICES

Practice address

104 S 7TH St
Clinton, OK 73601

Phone

(580) 402-1696

NPI assigned

May 31, 2018

Organization subpart

No

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

Authorized official

Name

James Gichuki, MS, LPC

Title

Director/Owner

Phone

(580) 402-1696

Specialties & licenses 1

Addresses

Other names 1

• Dynamic Psychological & Mediation Services Doing business as

Locations

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1477045995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 GRANITE WASH",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736013649",
            "telephone_number": "580-402-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S 7TH ST",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "73601",
            "telephone_number": "580-402-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PSYCHOLOGICAL & MEDIATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "GICHUKI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "580-402-1696",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "6010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Psychological & Mediation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsay Dlugonski
• Loretta June Dougherty
• Kimberly Brooke Douglas
• Sally Drinnon, DOCTOR OF PHARMACY
• Terra Deanne Dupree, OTR/L
• Mitzie Eaton
• Ronald E Edgar, DC
• Kyle Edwards, APRN FNP-C
• Kenneth M Egan, M.D.
• Kim S Elkin, RN

• Mental Health Counselor in Clinton, OK
• Providers in Clinton, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.