Active NPI
Holly Trunk
- Professional Counselor
- Okmulgee, OK
National Provider Identifier
1881987899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1330
- Practice address
- 1803 S Wood Dr
Okmulgee, OK 74447-6825 - Phone
- (918) 756-9250
- NPI assigned
- May 24, 2011
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1330 | OK | |
| Professional Counselor | 101YP2500X | 1330 | OK | Primary |
Addresses
Primary practice location
1803 S Wood Dr
Okmulgee, OK 74447-6825
Mailing address
1803 S Wood Dr
Okmulgee, OK 74447-6825
Phone (918) 756-9250
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | holly.trunk@creoks.org | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1330 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593043200000",
"number": "1881987899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 S WOOD DR",
"city": "OKMULGEE",
"state": "OK",
"postal_code": "744476825",
"telephone_number": "918-756-9250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 S WOOD DR",
"city": "OKMULGEE",
"state": "OK",
"postal_code": "744476825",
"telephone_number": "918-756-9250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUNK",
"first_name": "HOLLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-24",
"last_updated": "2020-06-25",
"certification_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OK",
"license": "1330",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "1330",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "holly.trunk@creoks.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1803 S Wood Dr",
"city": "Okmulgee",
"state": "OK",
"country_code": "US",
"postal_code": "744476825",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.