NPIMap

Organization Active NPI

Family Therapy and Renewal Center PLLC

  • Professional Counselor
  • Tulsa, OK
National Provider Identifier
1689919482
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3752 Issued in OK
Legal business name
FAMILY THERAPY AND RENEWAL CENTER PLLC
Practice address
6717 S Yale Ave Ste 202
Tulsa, OK 74136-3328
Phone
(918) 369-4950
Fax
(918) 369-4951
NPI assigned
Dec 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Authorized official

Name
Talitha Susan Bachmann, LPCNPI 1215035522
Title
Member
Phone
(918) 369-4950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 3728 OK
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 3752 OK Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 982 OK

Addresses

Primary practice location

6717 S Yale Ave Ste 202
Tulsa, OK 74136-3328

Mailing address

6717 S Yale Ave Ste 202
Tulsa, OK 74136-3328
Phone (918) 369-4950

Other practice location 1

8321 E 61st St Ste 205
Tulsa, OK 74133-1911
Phone (918) 269-4159

Other identifiers 1

IdentifierTypeStateIssuer
200467210AMedicaidOK

National Provider Directory

National Provider Directory

Locations

8321 E 61st St
Ste 205
Tulsa, OK 74133
Phone (918) 269-4159

6717 S Yale Ave
Ste 202
Tulsa, OK 74136
Phone (918) 369-4950

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1689919482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6717 S YALE AVE STE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363328",
            "telephone_number": "918-369-4950",
            "fax_number": "918-369-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6717 S YALE AVE STE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363328",
            "telephone_number": "918-369-4950",
            "fax_number": "918-369-4951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8321 E 61st St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741331911",
            "country_code": "US",
            "telephone_number": "918-269-4159",
            "fax_number": "918-369-4951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY THERAPY AND RENEWAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "BACHMANN",
        "authorized_official_first_name": "TALITHA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "918-369-4950",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3728",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3752",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "982",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200467210A",
            "state": "OK"
        }
    ],
    "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 27, 2017; 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.