Active NPI
Jessica L Lawley, LPC
- Professional Counselor
- Tishomingo, OK
National Provider Identifier
1740549344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5788
- Practice address
- 610 E 24TH St
Tishomingo, OK 73460-3245 - Phone
- (580) 371-2343
- Fax
- (580) 371-2451
- NPI assigned
- May 16, 2012
- Last updated
- Sep 1, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5788 | OK | Primary |
Addresses
Primary practice location
610 E 24TH St
Tishomingo, OK 73460-3245
Mailing address
610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 371-2343
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200435710 B | Medicaid | OK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5788 | OK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441065600000",
"number": "1740549344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E 24TH ST",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734603245",
"telephone_number": "580-371-2343",
"fax_number": "580-371-2451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 E 24TH ST",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734603245",
"telephone_number": "580-371-2343",
"fax_number": "580-371-2451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWLEY",
"first_name": "JESSICA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-16",
"last_updated": "2015-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "5788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200435710 B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tishomingo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.