Individual provider Active NPI

Sidney Marie Stover, MS

  • Marriage & Family Therapist
  • Oklahoma City, OK
National Provider Identifier
1881360360
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
10611 Issued in OK
Practice address
4436 NW 50TH St
Oklahoma City, OK 73112-2212
Phone
(405) 858-2700
NPI assigned
Aug 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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 10611 OK Primary

Addresses

Primary practice location

4436 NW 50TH St
Oklahoma City, OK 73112-2212

Mailing address

4436 NW 50TH St
Oklahoma City, OK 73112-2212
Phone (405) 858-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241010003731 OK Practitioner - Marriage and Family Therapist 0840722120 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
10611OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Oklahoma County Mental Health Center CurrentSince Aug 9, 2024 Accepting new patients
Tri-City Youth & Family Center, Inc. PastSince Aug 1, 2021 Accepting new patients
Tri-City Youth & Family Center, Inc. PastSince Aug 1, 2021 Accepting new patients

Locations

2617 General Pershing Blvd
Oklahoma City, OK 73107
Phone (405) 858-1700

4436 NW 50th St
Oklahoma City, OK 73112
Phone (405) 272-0660

Organizations & group practices 3

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1881360360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 NW 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122212",
            "telephone_number": "405-858-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4436 NW 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122212",
            "telephone_number": "405-858-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "SIDNEY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "10611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.