Jimmy L Widdifield Jr., M.A., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

940 NE 13TH St
4N 4900
Oklahoma City, OK 73104-5008

Phone

(405) 271-8858

Fax

(405) 271-2931

NPI assigned

Mar 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1710157136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 W NICKLAS AVE",
            "address_2": "APT. B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731326933",
            "telephone_number": "405-412-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST",
            "address_2": "4N 4900",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-8858",
            "fax_number": "405-271-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDIFIELD",
        "first_name": "JIMMY",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Wicks
• Teresa C Wicks
• Wickshire Oklahoma City Opco LLC
• Mylla Jaylynn Wickwire, PHARM.D.
• Elizabeth H. Widaski, RN
• Jeremy Eugene Widener, DO
• Frank J. Wiebelt, D.D.S.
• Jessica Tompkins Wieduwilt, CRNA
• Matthew David Wiefels, MD
• Robert Jerome Wienecke, M.D.

• Mental Health Counselor in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.