NPIMap

Organization Active NPI

N-Sideout Counseling Services, PLLC

  • Mental Health Counselor
  • Oklahoma City, OK
National Provider Identifier
1619357936
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5120 Issued in OK
Legal business name
N-SIDEOUT COUNSELING SERVICES, PLLC
Practice address
1330 N Classen Blvd Ste 315
Oklahoma City, OK 73106-6834
Phone
(405) 606-2880
Fax
(405) 606-2881
NPI assigned
Jun 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Authorized official

Name
Jeanette Loudermilk, LPC
Title
Clinical Director
Phone
(405) 606-2880

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X 5120 OK
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 5120 OK Primary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 5120 OK
PsychoanalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 102L00000X 5120 OK

Addresses

Primary practice location

1330 N Classen Blvd Ste 315
Oklahoma City, OK 73106-6834

Mailing address

1330 N Classen Blvd Ste 315
Oklahoma City, OK 73106-6834
Phone (405) 606-2880

Other identifiers 1

IdentifierTypeStateIssuer
200412190BMedicaidOK

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1619357936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 N CLASSEN BLVD STE 315",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731066834",
            "telephone_number": "405-606-2880",
            "fax_number": "405-606-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N CLASSEN BLVD STE 315",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731066834",
            "telephone_number": "405-606-2880",
            "fax_number": "405-606-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N-SIDEOUT COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "LOUDERMILK",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "405-606-2880",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "OK",
            "license": "5120",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "5120",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5120",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "OK",
            "license": "5120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200412190B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.