Active NPI
Michael Stephen, PHD
- Psychologist
- Oklahoma City, OK
National Provider Identifier
1942212097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 540
- Practice address
- 4200 W Memorial Rd
#801
Oklahoma City, OK 73120-9350 - Phone
- (405) 858-8777
- Fax
- (405) 858-8777
- NPI assigned
- Aug 13, 2006
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Counseling Psychologist | 103TC1900X | 540 | OK | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 540 | OK | |
| Exercise & Sports Psychologist | 103TE1100X | 540 | OK | |
| Family Psychologist | 103TF0000X | 540 | OK | |
| Psychologist | 103T00000X | 540 | OK | Primary |
Addresses
Primary practice location
4200 W Memorial Rd
#801
Oklahoma City, OK 73120-9350
Mailing address
4200 W Memorial Rd
#801
Oklahoma City, OK 73120-9350
Phone (405) 858-8777
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 540 | OK | MD | Addiction (Substance Use Disorder) Counselor |
| 580 | OK | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496275200000",
"number": "1942212097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 W MEMORIAL RD",
"address_2": "#801",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731209350",
"telephone_number": "405-858-8777",
"fax_number": "405-858-8777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 W MEMORIAL RD",
"address_2": "#801",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731209350",
"telephone_number": "405-858-8777",
"fax_number": "405-858-8777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHEN",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2017-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "OK",
"license": "540",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "OK",
"license": "540",
"primary": false
},
{
"code": "103TE1100X",
"taxonomy_group": "",
"desc": "Psychologist, Exercise & Sports",
"state": "OK",
"license": "540",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "OK",
"license": "540",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OK",
"license": "540",
"primary": true
}
],
"identifiers": [],
"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 Jun 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.