Kathleen Ellison Nicholas, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3390 Issued in OK

Practice address

6417 S Kingston Ave
Tulsa, OK 74136-2112

Phone

(918) 798-3196

NPI assigned

Feb 2, 2009

Last updated

Apr 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Broken Arrow, OK
  • NPI 1689228272
  NPD (past)

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1912145723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6417 S KINGSTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362112",
            "telephone_number": "918-798-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 S KINGSTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362112",
            "telephone_number": "918-798-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "KATHLEEN",
        "middle_name": "ELLISON",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuong-Lan Pham Nguyen, PHARMD
• Uyen T Nguyen
• Vivian Nguyen
• Shana Niccum, LPC
• Jayse Michelle Nicholas
• Rebecca Lynn Nicholas, PSYCHOLOGIST, ED.D.
• Amanda J Nichols, DO
• Christopher Daniel Nichols, LMSW
• Felicia Marie Nichols, RN
• Jessica Ann Nichols, LMT

• Speech-Language Pathologist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.