NPIMap

Organization Active NPI

Logan Community Services

  • Addiction (Substance Use Disorder) Counselor
  • Guthrie, OK
National Provider Identifier
1669590949
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
LOGAN COMMUNITY SERVICES
Practice address
4710 S Division St
Guthrie, OK 73044-6506
Phone
(405) 282-5524
NPI assigned
Mar 26, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Nichole D Graves, LPC, LADC
Title
Clinical Director
Phone
(405) 282-5524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X OK Primary

Addresses

Primary practice location

4710 S Division St
Guthrie, OK 73044-6506

Mailing address

PO Box 1558
Guthrie, OK 73044-1558
Phone (405) 282-5524

Other identifiers 1

IdentifierTypeStateIssuer
100733910AMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Logan Community Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669590949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1558",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730441558",
            "telephone_number": "405-282-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 S DIVISION ST",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730446506",
            "telephone_number": "405-282-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "405-282-5524",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100733910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.