Organization Active NPI

Edmondson Family Therapy

  • Community/Behavioral Health Agency
  • Edmond, OK
National Provider Identifier
1659709608
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
5028 Issued in OK
Legal business name
EDMONDSON FAMILY THERAPY
Practice address
1015 Waterwood Pkwy
Suite G, L-2
Edmond, OK 73034-5327
Phone
(405) 315-7093
NPI assigned
Oct 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Authorized official

Name
Jennifer Erin Edmondson, MA, LPC, LADC, CMIII
Title
Licensed Professional Counselor
Phone
(405) 315-7093

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 1067 OK
Community/Behavioral Health Agency 251S00000X 5028 OK Primary

Addresses

Primary practice location

1015 Waterwood Pkwy
Suite G, L-2
Edmond, OK 73034-5327

Mailing address

1015 Waterwood Pkwy
Suite G, L-2
Edmond, OK 73034-5327
Phone (405) 315-7093

National Provider Directory

National Provider Directory

Locations

1015 Waterwood Pkwy
Ste G-L2
Edmond, OK 73034
Phone (405) 315-7093

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1659709608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WATERWOOD PKWY",
            "address_2": "SUITE G, L-2",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345327",
            "telephone_number": "405-315-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WATERWOOD PKWY",
            "address_2": "SUITE G, L-2",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345327",
            "telephone_number": "405-315-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDSON FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "EDMONDSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ERIN",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "405-315-7093",
        "authorized_official_credential": "MA, LPC, LADC, CMIII"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OK",
            "license": "1067",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "5028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.