Individual provider Active NPI

Namik Kirlic, PHD

  • Clinical Psychologist
  • Tulsa, OK
National Provider Identifier
1649530023
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1333 Issued in OK
Practice address
1304 W Easton St
Tulsa, OK 74127-6903
Phone
(617) 800-4028
NPI assigned
May 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1333 OK Primary

Addresses

Primary practice location

1304 W Easton St
Tulsa, OK 74127-6903

Mailing address

1304 W Easton St
Tulsa, OK 74127-6903
Phone (617) 800-4028

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1333OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Health Care Resource Center PastSince Mar 24, 2003 Accepting new patients
Indian Health Care Resource Center of Tulsa, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1649530023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 W EASTON ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741276903",
            "telephone_number": "617-800-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W EASTON ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741276903",
            "telephone_number": "617-800-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRLIC",
        "first_name": "NAMIK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1333",
            "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 Oct 18, 2019; 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.