Active NPI
Shelby Johnson, PH.D.
- Counseling Psychologist
- Tulsa, OK
National Provider Identifier
1770957342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 1419
- Practice address
- 2912 E 75TH CT
Tulsa, OK 74136-5640 - Phone
- (405) 640-7251
- NPI assigned
- Nov 19, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 4873 | NC | |
| Counseling Psychologist | 103TC1900X | 1419 | OK | Primary |
Addresses
Primary practice location
2912 E 75TH CT
Tulsa, OK 74136-5640
Mailing address
2912 E 75TH CT
Tulsa, OK 74136-5640
Phone (405) 640-7251
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1419 | OK | MD | Registered Dietitian |
| 4873 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1770957342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2912 E 75TH CT",
"city": "TULSA",
"state": "OK",
"postal_code": "741365640",
"telephone_number": "405-640-7251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2912 E 75TH CT",
"city": "TULSA",
"state": "OK",
"postal_code": "741365640",
"telephone_number": "405-640-7251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SHELBY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-19",
"last_updated": "2022-10-14",
"certification_date": "2022-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NC",
"license": "4873",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "OK",
"license": "1419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.