Active NPI
Tiffany C Chancellor, LMSW
- Social Worker
- Yukon, OK
National Provider Identifier
1780439679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 20628-P
- Practice address
- 1209 Kingston Dr
Yukon, OK 73099-5413 - Phone
- (405) 593-3280
- NPI assigned
- Apr 23, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 20628-P | OK | Primary |
Addresses
Primary practice location
1209 Kingston Dr
Yukon, OK 73099-5413
Mailing address
1209 Kingston Dr
Yukon, OK 73099-5413
Phone (405) 593-3280
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 |
|---|---|---|---|
| 20628-P | OK | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1780439679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 KINGSTON DR",
"city": "YUKON",
"state": "OK",
"postal_code": "730995413",
"telephone_number": "405-593-3280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1209 KINGSTON DR",
"city": "YUKON",
"state": "OK",
"postal_code": "730995413",
"telephone_number": "405-593-3280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANCELLOR",
"first_name": "TIFFANY",
"middle_name": "C",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-23",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OK",
"license": "20628-P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yukon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.