NPIMap

Organization Active NPI

Sequelcare of Oklahoma, LLC

  • Behavior Analyst
  • Tulsa, OK
National Provider Identifier
1932876976
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SEQUELCARE OF OKLAHOMA, LLC
Practice address
6218 S Lewis Ave Ste 118
Tulsa, OK 74136-1018
Phone
(539) 302-0361
Fax
(580) 298-6723
NPI assigned
Aug 26, 2021
Last updated
Aug 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SEQUELCARE OF OKLAHOMA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Darlissa Dunn
Title
Human Resource Manager
Phone
(580) 298-2830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

6218 S Lewis Ave Ste 118
Tulsa, OK 74136-1018

Mailing address

PO Box 1030
Antlers, OK 74523-1030
Phone (580) 298-2830

Other identifiers 1

IdentifierTypeStateIssuer
200946050AMedicaidOK

Other names 2

  • Camelot Community Services of OK Former legal business name
  • Camelot Community Services of Oklahoma Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Camelot Community Services of Oklahoma LLC36 organizations share this tax ID, including this one
Part of
Camelot Community Services of Oklahoma LLC

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1932876976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "ANTLERS",
            "state": "OK",
            "postal_code": "745231030",
            "telephone_number": "580-298-2830",
            "fax_number": "580-298-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6218 S LEWIS AVE STE 118",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361018",
            "telephone_number": "539-302-0361",
            "fax_number": "580-298-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUELCARE OF OKLAHOMA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUELCARE OF OKLAHOMA, LLC",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "DARLISSA",
        "authorized_official_title_or_position": "HUMAN RESOURCE MANAGER",
        "authorized_official_telephone_number": "580-298-2830"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200946050A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot Community Services of OK",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Camelot Community Services of Oklahoma",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Aug 26, 2021; 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.