Kallie D Jones, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

8225 Issued in OK

Practice address

423 W Broadway Ave
Enid, OK 73701-3839

Phone

(580) 922-5656

Fax

(580) 922-3261

NPI assigned

May 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kallie D Brakhage Other 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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Bent Creek Behavioral Health Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Woodward, OK
  • NPI 1518623735
  Medicare reassignment NPD

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1598387060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 177",
            "city": "SEILING",
            "state": "OK",
            "postal_code": "736630177",
            "telephone_number": "580-922-5656",
            "fax_number": "580-922-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 W BROADWAY AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013839",
            "telephone_number": "580-922-5656",
            "fax_number": "580-922-3261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 19th St",
            "address_purpose": "LOCATION",
            "city": "Woodward",
            "state": "OK",
            "postal_code": "738012925",
            "country_code": "US",
            "telephone_number": "580-922-5656",
            "fax_number": "580-922-3261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "KALLIE",
        "middle_name": "D",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "8225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALLIE",
            "last_name": "BRAKHAGE",
            "middle_name": "D",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Angela D Johnston, PA-C
• Ashley Dawn Jones, PA-C
• Benjamin Richard Jones, DMD
• Brittaney Jones
• Jeffrey R Jones, DO
• Kanani Jones
• Katana Serrano Jones, LMSW
• Kayla Jean Jones
• Nicole R Jones
• Robert D Jones

• Social Worker in Enid, OK
• Providers in Enid, OK by specialty
• Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.