Individual provider Active NPI

Amy E Southerland, LMFT

  • Marriage & Family Therapist
  • Oklahoma City, OK
National Provider Identifier
1750808325
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1371 Issued in OK
Practice address
3000 United Founders Blvd Ste 139D
Oklahoma City, OK 73112-4359
Phone
(405) 259-6155
NPI assigned
Aug 24, 2017
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X 1371 OK Primary

Addresses

Primary practice location

3000 United Founders Blvd Ste 139D
Oklahoma City, OK 73112-4359

Mailing address

3000 United Founders Blvd Ste 139D
Oklahoma City, OK 73112-4359
Phone (405) 259-6155

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

LicenseStateTypeSpecialty
1371OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Oak Family Therapy, PLLC CurrentSince Oct 24, 2021 Accepting new patients
Instilling Hope & Wellness LLC PastSince Mar 1, 2020 Accepting new patients

Locations

12220 N MacArthur Blvd
Ste F61
Oklahoma City, OK 73162

2828 NW 57th St
Ste 119
Oklahoma City, OK 73112

3000 United Founders Blvd
Ste 139D
Oklahoma City, OK 73112
Phone (405) 259-6155

3033 NW 63rd St
Ste 160E
Oklahoma City, OK 73116
Phone (405) 259-7443

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1750808325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 UNITED FOUNDERS BLVD STE 139D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124359",
            "telephone_number": "405-259-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 UNITED FOUNDERS BLVD STE 139D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124359",
            "telephone_number": "405-259-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "1371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.