Active NPI
David Steel Willis, III, LPC, NCP
- Professional Counselor
- Tulsa, OK
National Provider Identifier
1891989885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3645
- Practice address
- 3751 E 85TH St
Tulsa, OK 74137-1734 - Phone
- (918) 520-5476
- NPI assigned
- Sep 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3645 | OK | Primary |
Addresses
Primary practice location
3751 E 85TH St
Tulsa, OK 74137-1734
Mailing address
3751 E 85TH St
Tulsa, OK 74137-1734
Phone (918) 520-5476
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 |
|---|---|---|---|
| 3645 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188604800000",
"number": "1891989885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3751 E 85TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741371734",
"telephone_number": "918-520-5476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3751 E 85TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741371734",
"telephone_number": "918-520-5476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS,",
"first_name": "DAVID",
"middle_name": "STEEL",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LPC, NCP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-01",
"last_updated": "2007-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "3645",
"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 Sep 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.