Active NPI
Gordon Ray Whitewolf, LBP
- Mental Health Counselor
- Anadarko, OK
National Provider Identifier
1891940045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0216
- Practice address
- 101 Riverside Drive
Riverside Indian School
Anadarko, OK 73005 - Phone
- (405) 247-6670
- Fax
- (405) 247-2029
- NPI assigned
- Dec 1, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 386 | OK | |
| Mental Health Counselor | 101YM0800X | 0216 | OK | Primary |
Addresses
Primary practice location
101 Riverside Drive
Riverside Indian School
Anadarko, OK 73005
Mailing address
101Riverside Drive
Anadarko, OK 73005
Phone (405) 247-6670
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 |
|---|---|---|---|
| 0216 | OK | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228089600000",
"number": "1891940045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101RIVERSIDE DRIVE",
"city": "ANADARKO",
"state": "OK",
"postal_code": "73005",
"telephone_number": "405-247-6670",
"fax_number": "405-247-2029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 RIVERSIDE DRIVE",
"address_2": "RIVERSIDE INDIAN SCHOOL",
"city": "ANADARKO",
"state": "OK",
"postal_code": "73005",
"telephone_number": "405-247-6670",
"fax_number": "405-247-2029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEWOLF",
"first_name": "GORDON",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "LBP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-01",
"last_updated": "2008-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OK",
"license": "386",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "0216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anadarko, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.