Individual provider Active NPI

Chantri Payne, LCSW

  • Clinical Social Worker
  • Okemah, OK
National Provider Identifier
1497177117
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7077 Issued in OK
Practice address
119 S 1St St
Okemah, OK 74859-4010
Phone
(918) 623-2922
Fax
(918) 623-9316
NPI assigned
Jan 15, 2014
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7077 OK Primary

Addresses

Primary practice location

119 S 1St St
Okemah, OK 74859-4010

Mailing address

119 S 1St St
Okemah, OK 74859-4010
Phone (918) 623-2922

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231030003136 OK Practitioner - Clinical Social Worker 9931555760 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creoks Mental Health CurrentSince Sep 14, 2023 Accepting new patients
Creoks Mental Health Services CurrentSince Sep 14, 2023 Accepting new patients
Creoks Mental Health Services Current Accepting new patients

Locations

209 W Broadway St
Okemah, OK 74859
Phone (918) 623-2922

4103 S Yale Ave
Ste B
Tulsa, OK 74135
Phone (918) 382-7302

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1497177117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S 1ST ST",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "748594010",
            "telephone_number": "918-623-2922",
            "fax_number": "918-623-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S 1ST ST",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "748594010",
            "telephone_number": "918-623-2922",
            "fax_number": "918-623-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "CHANTRI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "7077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemah, OK

Sources for this page

Verify at the official NPI Registry.