Full Sail Behavioral Health Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FULL SAIL BEHAVIORAL HEALTH COUNSELING LLC

Practice address

3602 N Union Ave
Shawnee, OK 74804-2158

Phone

(918) 284-5658

NPI assigned

Mar 2, 2020

Organization subpart

No

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

Authorized official

Name

Melissa Sue Upton, LPCNPI 1205178209

Title

Owner/Operator

Phone

(918) 284-5658

Specialties & licenses 1

Addresses

Practitioners 1

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

• Melissa Sue Upton, MS

  • Mental Health Counselor
  • Oklahoma City, OK
  • NPI 1205178209
  NPD (past) Authorized official

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1730713538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 N UNION AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042158",
            "telephone_number": "918-284-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 N UNION AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042158",
            "telephone_number": "918-284-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SAIL BEHAVIORAL HEALTH COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "UPTON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "918-284-5658",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Freeman
• Jaylee M Friend
• Bridgett Shyann Frizzell
• Jacquelyn Deann Fry, PHARMD
• Kendra Fugate
• Torie Ann Fuller, M.S., R.D.
• Kereon Gallagher
• Ashley Dawn Gambrell, BHWC
• Elizabeth Gamel, LPN
• Lauren Watts Garcia

• Mental Health Clinic/Center (Including Community Mental Health Center) in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.