Carol Ellise O'Bryan, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

895 Issued in OK

Practice address

301 S Poplar Ave
Broken Arrow, OK 74012-8396

Phone

(918) 251-1662

NPI assigned

Dec 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1528127388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S GARNETT RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741281805",
            "telephone_number": "918-438-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S POPLAR AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128396",
            "telephone_number": "918-251-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "CAROL",
        "middle_name": "ELLISE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "895",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2007002866",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2006029726",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4025",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "798",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Marriage & Family Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.