Individual provider Active NPI

Cydney, Majiyashekwe Lynn Bgembisa, COUNSELOR

  • Counselor
  • Wagoner, OK
National Provider Identifier
1649820317
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
11536 Issued in OK
Practice address
109 S Harrill Ave
Wagoner, OK 74467-5317
Phone
(918) 485-0224
NPI assigned
Sep 16, 2019
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 11536 OK Primary
Behavior Technician 106S00000X K083262361 OK

Addresses

Primary practice location

109 S Harrill Ave
Wagoner, OK 74467-5317

Mailing address

109 S Harrill Ave
Wagoner, OK 74467-5317
Phone (405) 918-4850

Other practice location 1

930 Wall St
Norman, OK 73069-6319
Phone (405) 384-8588 ext. 40538

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

State licenses

LicenseStateTypeSpecialty
11536OKMDCounselor
K083262361OKMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1649820317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S HARRILL AVE",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744675317",
            "telephone_number": "405-918-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S HARRILL AVE",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744675317",
            "telephone_number": "918-485-0224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Wall St",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730696319",
            "country_code": "US",
            "telephone_number": "405-384-8588 x40538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BGEMBISA",
        "first_name": "CYDNEY, MAJIYASHEKWE",
        "middle_name": "LYNN",
        "credential": "COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "11536",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OK",
            "license": "K083262361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.