Active NPI
Latanya Dodd
- Adult Mental Health Clinic/Center
- Tulsa, OK
National Provider Identifier
1912337643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- License
- 261QM0850X
- Practice address
- 1540 E 68TH PL
Tulsa, OK 74136 - Phone
- (317) 457-3933
- NPI assigned
- Nov 15, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | 261QM0850X | OK | Primary |
Addresses
Primary practice location
1540 E 68TH PL
Tulsa, OK 74136
Mailing address
1540 E 68TH PL
Tulsa, OK 74136-4119
Phone (317) 457-3933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5400-21-9970 | Other | OK | OKLAHOMA DRIVERS LISCENSE |
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 |
|---|---|---|---|
| 261QM0850X | OK | MD | Adult Mental Health Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384473600000",
"number": "1912337643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 E 68TH PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741364119",
"telephone_number": "317-457-3933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 E 68TH PL",
"city": "TULSA",
"state": "OK",
"postal_code": "74136",
"telephone_number": "317-457-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODD",
"first_name": "LATANYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-15",
"last_updated": "2013-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": "OK",
"license": "261QM0850X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA DRIVERS LISCENSE",
"identifier": "5400-21-9970",
"state": "OK"
}
],
"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 Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.