Individual provider Active NPI

Cleatta Shumate-Johnson, M.ED., LPC

  • Professional Counselor
  • Tulsa, OK
National Provider Identifier
1598702987
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2503 Issued in OK
Practice address
3311 E 46TH St
Tulsa, OK 74135-2903
Phone
(918) 747-8282
Fax
(918) 747-6601
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2503 OK Primary

Addresses

Primary practice location

3311 E 46TH St
Tulsa, OK 74135-2903

Mailing address

2140 N Waco Ave
Tulsa, OK 74127-2221
Phone (918) 587-8916

Other names 1

  • Prof. Cleatta Shumate Professional name

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2503OKMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1598702987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 N WACO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741272221",
            "telephone_number": "918-587-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 E 46TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352903",
            "telephone_number": "918-747-8282",
            "fax_number": "918-747-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMATE-JOHNSON",
        "first_name": "CLEATTA",
        "name_prefix": "Mrs.",
        "credential": "M.ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLEATTA",
            "last_name": "SHUMATE",
            "prefix": "PROF.",
            "credential": "M.ED., LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Dec 17, 2009; 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.