Organization Active NPI

Private Psychiatric Care

  • Psychiatry Physician
  • Tulsa, OK
National Provider Identifier
1588942015
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PRIVATE PSYCHIATRIC CARE
Practice address
907 S Detroit Ave Ste 1075
Tulsa, OK 74120-4276
Phone
(918) 856-3436
Fax
(877) 245-1779
NPI assigned
Aug 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Authorized official

Name
Selena Melanese Parks
Title
Ceo
Phone
(405) 708-6999

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Group Psychotherapy PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TP2701X
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

907 S Detroit Ave Ste 1075
Tulsa, OK 74120-4276

Mailing address

4845 S Sheridan Rd
504
Tulsa, OK 74145-5751
Phone (918) 856-3436

National Provider Directory

National Provider Directory

Locations

907 S Detroit Ave
Ste 1075
Tulsa, OK 74120
Phone (918) 856-3436

4845 S Sheridan Rd
Ste 504
Tulsa, OK 74145

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523836800000",
    "number": "1588942015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 S SHERIDAN RD",
            "address_2": "504",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741455751",
            "telephone_number": "918-856-3436",
            "fax_number": "877-245-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 S DETROIT AVE STE 1075",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204276",
            "telephone_number": "918-856-3436",
            "fax_number": "877-245-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE PSYCHIATRIC CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2018-04-16",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "SELENA",
        "authorized_official_middle_name": "MELANESE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-708-6999"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "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 Apr 16, 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.