Active NPI
Christy Tanusaputra, MA, NCC, LPC, LAC
- Professional Counselor
- Tulsa, OK
National Provider Identifier
1679843189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10674
- Practice address
- 5200 S Yale Ave Ste 400
Tulsa, OK 74135-7489 - Phone
- (918) 236-0150
- NPI assigned
- Jan 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0011344 | CO | |
| Professional Counselor | 101YP2500X | 10674 | OK | Primary |
| Counselor | 101Y00000X | 12274 | CO | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 325 | CO |
Addresses
Primary practice location
5200 S Yale Ave Ste 400
Tulsa, OK 74135-7489
Mailing address
4038 E 53Rd St
Tulsa, OK 74135-4816
Phone (918) 688-0903
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0011344 | CO | MD | Professional Counselor |
| 10674 | OK | MD | Professional Counselor |
| 325 | CO | MD | Clinical Social Worker |
| 12274 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700956800000",
"number": "1679843189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4038 E 53RD ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741354816",
"telephone_number": "918-688-0903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 S YALE AVE STE 400",
"city": "TULSA",
"state": "OK",
"postal_code": "741357489",
"telephone_number": "918-236-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANUSAPUTRA",
"first_name": "CHRISTY",
"credential": "MA, NCC, LPC, LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-01",
"last_updated": "2023-11-26",
"certification_date": "2023-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "0011344",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "10674",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "12274",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "325",
"primary": false
}
],
"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 Nov 26, 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.