Jessica Stombaugh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5015 Issued in OK

Practice address

808 S Peoria Ave
Tulsa, OK 74120-4427

Phone

(918) 560-1300

NPI assigned

Apr 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jessica Scott Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Viemed Clinical Services, LLC

  • Clinical Social Worker
  • Tulsa, OK
  • NPI 1528648227
  Medicare reassignment NPD
• Family & Children'S Services, Inc

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1861099566
  NPD
• Viemed Clinical Services, LLC

  • Clinical Social Worker
  • Mount Pleasant, SC
  • NPI 1811629629
  NPD
• Melton Health and Medical Services

  • Mental Health Counselor
  • Broken Arrow, OK
  • NPI 1093123101
  NPD (past)

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1487074787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204427",
            "telephone_number": "918-560-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204427",
            "telephone_number": "918-560-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOMBAUGH",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "5015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SCOTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin Stolinski, OTR
• Sawyer Stolle
• David Alan Stoller, DPM
• Julie A Stolt, OTR/L
• Gina Lavella Stolz, D.D.S.
• Stone M. Hallquist M. D. Inc.
• Amy Elizabeth Stone, DDS
• Angel Dyan Stone, BS, CM-D, BHRS
• Angela Marie Stone
• Brandon Stone

• Clinical Social Worker in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.