Organization Active NPI

Paths of Change Inc

  • Psychologist
  • Bartlesville, OK
National Provider Identifier
1851495196
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PATHS OF CHANGE INC
Practice address
102 1/2 SW Frank Phillips
Room 4
Bartlesville, OK 74003-6606
Phone
(918) 336-1234
Fax
(918) 336-7604
NPI assigned
Sep 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Shanon Elizabeth Braden, PHD LPC
Title
President
Phone
(918) 336-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

102 1/2 SW Frank Phillips
Room 4
Bartlesville, OK 74003-6606

Mailing address

102 1/2 SW Frank Phillips
Room 4
Bartlesville, OK 74003
Phone (918) 336-1234

National Provider Directory

National Provider Directory

Locations

102 12 SW Frank Phillips
RM 4
Bartlesville, OK 74003
Phone (918) 336-1234

Practitioners & affiliated clinicians

Practitioners 1

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": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851495196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 1/2 SW FRANK PHILLIPS",
            "address_2": "ROOM 4",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74003",
            "telephone_number": "918-336-1234",
            "fax_number": "918-336-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 1/2 SW FRANK PHILLIPS",
            "address_2": "ROOM 4",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740036606",
            "telephone_number": "918-336-1234",
            "fax_number": "918-336-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHS OF CHANGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADEN",
        "authorized_official_first_name": "SHANON",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-336-1234",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD LPC"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.