Individual provider Active NPI

Kami Lyn Gallus, PH.D., LMFT

  • Marriage & Family Therapist
  • Stillwater, OK
National Provider Identifier
1780890103
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
920 Issued in OK
Practice address
233 Hes
Center for Family Services
Stillwater, OK 74078-6120
Phone
(405) 744-8351
Fax
(405) 744-2800
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 920 OK Primary

Addresses

Primary practice location

233 Hes
Center for Family Services
Stillwater, OK 74078-6120

Mailing address

233 Nancy Randolph Davis Oklahoma State University
Stillwater, OK 74078-6120
Phone (405) 744-8351

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

LicenseStateTypeSpecialty
920OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1780890103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 NANCY RANDOLPH DAVIS OKLAHOMA STATE UNIVERSITY",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740786120",
            "telephone_number": "405-744-8351",
            "fax_number": "405-744-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 HES",
            "address_2": "CENTER FOR FAMILY SERVICES",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740786120",
            "telephone_number": "405-744-8351",
            "fax_number": "405-744-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUS",
        "first_name": "KAMI",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.