NPIMap

Organization Active NPI

Tri-City Youth & Family Center, Inc.

  • Mental Health Counselor
  • Choctaw, OK
National Provider Identifier
1881775211
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
TRI-CITY YOUTH & FAMILY CENTER, INC.
Practice address
14625 NE 23Rd St
Choctaw, OK 73020-8728
Phone
(405) 390-8131
Fax
(405) 390-8134
NPI assigned
Oct 19, 2006
Last updated
Jun 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Mr. Donald J. Abbott, LCSW
Title
Executive Director
Phone
(405) 390-8131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

14625 NE 23Rd St
Choctaw, OK 73020-8728

Mailing address

PO Box 695
Choctaw, OK 73020-0695
Phone (405) 390-8131

Other identifiers 1

IdentifierTypeStateIssuer
100732420AMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Tri-City Youth Family Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1881775211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 695",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730200695",
            "telephone_number": "405-390-8131",
            "fax_number": "405-390-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14625 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208728",
            "telephone_number": "405-390-8131",
            "fax_number": "405-390-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITY YOUTH & FAMILY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "405-390-8131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100732420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Choctaw, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.