Sydney Natosha Humphrey, MSW, LCSW, RPT-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4514 Issued in OK

Practice address

631 E. Court St.
Atoka, OK 74525

Phone

(580) 889-0960

NPI assigned

Aug 25, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sydney Natosha Kellett Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Texas a & M University System, HSC, College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Medical of Michigan PCGroup PAC ID 9830562776, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brightside Medical of Michigan PC

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1144800350

  OK

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1750538484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 51",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "74525",
            "telephone_number": "580-889-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 E. COURT ST.",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "74525",
            "telephone_number": "580-889-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "SYDNEY",
        "middle_name": "NATOSHA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW, RPT-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "4514",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYDNEY",
            "last_name": "KELLETT",
            "middle_name": "NATOSHA",
            "credential": "MSW, LCSW, RPT-S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher David Horstman, CM
• Laticia L Howard
• Victoria Howard
• Tara L. Huddleston, M. ED.
• Justin J Humphrey
• Joseph Reed Hutchings, APRN-CNP
• Inca Commnity Services, Inc.
• Dakota Alan Ingram
• Kristi Denise Jack
• Mickey Dewayne Jack, BHRS

• Clinical Social Worker in Atoka, OK
• Providers in Atoka, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.