Tulsa Professional Psychology, PLLC

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

1118 Issued in OK

Legal business name

TULSA PROFESSIONAL PSYCHOLOGY, PLLC

Practice address

3144 S Winston Ave Ste a
Tulsa, OK 74135-2012

Phone

(918) 878-8072

Fax

(918) 878-8072

NPI assigned

May 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Doty, PSY.D.NPI 1124340732

Title

Co-President

Phone

(918) 878-8072

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Green Country Psychology Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 8

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

• Timothy Dale Doty, PSYD

  • Forensic Psychologist
  • Tulsa, OK
  • NPI 1124340732

  Clinical

  Medicare reassignment NPD Authorized official
• Erin Morgan Powell, LPC, ATR-BC

  • Mental Health Counselor
  • Tulsa, OK
  • NPI 1174380950
  Medicare reassignment NPD
• David Cole Milton, PHD

  • Counseling Psychologist
  • Tulsa, OK
  • NPI 1871335174
  NPD
• Amber M Nipper, PSYD

  • Clinical Psychologist
  • Owasso, OK
  • NPI 1609537406
  NPD
• Ryan Tack

  • Psychologist
  • Tulsa, OK
  • NPI 1467342568
  NPD
• Victoria Leigh Tracy, PH.D.

  • Clinical Psychologist
  • Tulsa, OK
  • NPI 1336448455
  NPD
• Rebecca Joan Hurst, PHD

  • Counseling Psychologist
  • Tulsa, OK
  • NPI 1689177339
  NPD (past)
• Joseph E-K James, PSYD, LPC

  • Psychologist
  • Tulsa, OK
  • NPI 1245530781
  NPD (past)

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1629569264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741126937",
            "telephone_number": "918-878-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 S WINSTON AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352012",
            "telephone_number": "918-878-8072",
            "fax_number": "918-878-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA PROFESSIONAL PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "DOTY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "918-878-8072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1225",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1118",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "OK",
            "license": "1118",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "OK",
            "license": "1225",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "OK",
            "license": "1118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200460890B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200466160A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Country Psychology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Service Psychologist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Health Service Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.