Active NPI
Suzanne Broyles, L.P.C.
- Professional Counselor
- Tulsa, OK
National Provider Identifier
1588741763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1949 LPC
- Practice address
- 4825 S Peoria Ave
Suite 7
Tulsa, OK 74105-4558 - Phone
- (918) 665-0208
- Fax
- (918) 665-0216
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1949 LPC | OK | Primary |
Addresses
Primary practice location
4825 S Peoria Ave
Suite 7
Tulsa, OK 74105-4558
Mailing address
2812 E 71St St
Tulsa, OK 74136-5527
Phone (918) 851-4584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1949 LPC | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588741763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2812 E 71ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741365527",
"telephone_number": "918-851-4584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 S PEORIA AVE",
"address_2": "SUITE 7",
"city": "TULSA",
"state": "OK",
"postal_code": "741054558",
"telephone_number": "918-665-0208",
"fax_number": "918-665-0216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROYLES",
"first_name": "SUZANNE",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "1949 LPC",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.