Active NPI
Mark W. Gorman, LPC
- Mental Health Counselor
- Edmond, OK
National Provider Identifier
1750452025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1164
- Practice address
- 3233 E Memorial Rd
Ste. 110
Edmond, OK 73013-7082 - Phone
- (405) 608-0545
- Fax
- (405) 286-0057
- NPI assigned
- Nov 10, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1164 | OK | Primary |
Addresses
Primary practice location
3233 E Memorial Rd
Ste. 110
Edmond, OK 73013-7082
Mailing address
3233 E Memorial Rd
Ste. 110
Edmond, OK 73013-7082
Phone (405) 608-0545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164 | Other | OK | LICENSE NUMBER, LPC. |
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 |
|---|---|---|---|
| 1164 | OK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750452025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3233 E MEMORIAL RD",
"address_2": "STE. 110",
"city": "EDMOND",
"state": "OK",
"postal_code": "730137082",
"telephone_number": "405-608-0545",
"fax_number": "405-286-0057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3233 E MEMORIAL RD",
"address_2": "STE. 110",
"city": "EDMOND",
"state": "OK",
"postal_code": "730137082",
"telephone_number": "405-608-0545",
"fax_number": "405-286-0057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "MARK",
"middle_name": "W.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "1164",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER, LPC.",
"identifier": "1164",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.