Active NPI
Elizabeth Page Brockwell, LCSW
- Clinical Social Worker
- Tulsa, OK
National Provider Identifier
1861694523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5868
- Practice address
- 6655 S Yale Ave
Tulsa, OK 74136-3326 - Phone
- (918) 491-3700
- Fax
- (918) 491-5740
- NPI assigned
- Jun 4, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 28348 | CA | |
| Clinical Social Worker | 1041C0700X | 5868 | OK | Primary |
Addresses
Primary practice location
6655 S Yale Ave
Tulsa, OK 74136-3326
Mailing address
7701 Warner Ave
#Q237
Huntington Beach, CA 92647-4773
Phone (714) 517-6318
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5868 | OK | MD | Professional Counselor |
| LCS 28348 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538611200000",
"number": "1861694523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7701 WARNER AVE",
"address_2": "#Q237",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926474773",
"telephone_number": "714-517-6318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741363326",
"telephone_number": "918-491-3700",
"fax_number": "918-491-5740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCKWELL",
"first_name": "ELIZABETH",
"middle_name": "PAGE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2018-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 28348",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "5868",
"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 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.