NPIMap

Organization Active NPI

Community Resource Professionals

  • Clinical Social Worker
  • Claremore, OK
National Provider Identifier
1821211087
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1175 Issued in OK
Legal business name
COMMUNITY RESOURCE PROFESSIONALS
Practice address
304 W Will Rogers Blvd
Claremore, OK 74017-7022
Phone
(918) 343-3456
Fax
(918) 343-3456
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
Mr. Gary Wilson, LCSW, LADCNPI 1518953603
Title
Clinical Social Worker
Phone
(918) 343-3456

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 1175 OK Primary

Addresses

Primary practice location

304 W Will Rogers Blvd
Claremore, OK 74017-7022

Mailing address

304 W Will Rogers Blvd
Claremore, OK 74017-7022
Phone (918) 343-3456

Other identifiers 2

IdentifierTypeStateIssuer
1175OtherOKSOCIAL WORK LICENSE
562OtherOKLADC LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

304 W Will Rogers Blvd
Claremore, OK 74017
Phone (918) 343-3456

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1821211087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W WILL ROGERS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740177022",
            "telephone_number": "918-343-3456",
            "fax_number": "918-343-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W WILL ROGERS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740177022",
            "telephone_number": "918-343-3456",
            "fax_number": "918-343-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESOURCE PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "918-343-3456",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, LADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "1175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "1175",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC LICENSE NUMBER",
            "identifier": "562",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.