Individual provider Active NPI

Rebeca A. Palmer, LCSW

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1912108283
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5802 Issued in OK
Practice address
4200 Perimeter Center Dr
Suite #245
Oklahoma City, OK 73112-2324
Phone
(916) 335-7857
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5802 OK Primary
Clinical Social Worker 1041C0700X 24591 CA

Addresses

Primary practice location

4200 Perimeter Center Dr
Suite #245
Oklahoma City, OK 73112-2324

Mailing address

1301 N Hunters Bridge Way
Mustang, OK 73064-7239
Phone (916) 335-7857

Other identifiers 2

IdentifierTypeStateIssuer
24591OtherCACALIFORNIA BOARD OF BEHAVIORAL SCIENCES
5802OtherOKOKLAHOMA STATE BOARD OF LICENSED SOCIAL WORKERS

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

LicenseStateTypeSpecialty
24591CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1912108283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N HUNTERS BRIDGE WAY",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647239",
            "telephone_number": "916-335-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 PERIMETER CENTER DR",
            "address_2": "SUITE #245",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122324",
            "telephone_number": "916-335-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "REBECA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "5802",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "24591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "24591",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE BOARD OF LICENSED SOCIAL WORKERS",
            "identifier": "5802",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.