Active NPI
Sophia Emma Thundu, M.A.
- Marriage & Family Therapist
- Tulsa, OK
National Provider Identifier
1952747370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- CANDIDATE
- Practice address
- 4122 W 55TH PL
Suite 119
Tulsa, OK 74107-9108 - Phone
- (918) 486-9996
- Fax
- (800) 260-7966
- NPI assigned
- May 13, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | CANDIDATE | OK | Primary |
Addresses
Primary practice location
4122 W 55TH PL
Suite 119
Tulsa, OK 74107-9108
Mailing address
PO Box 702504
Tulsa, OK 74170-2504
Phone (918) 486-9996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NEW ENROLLMENT | Medicaid | OK |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CANDIDATE | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404691200000",
"number": "1952747370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 702504",
"city": "TULSA",
"state": "OK",
"postal_code": "741702504",
"telephone_number": "918-486-9996",
"fax_number": "800-260-7966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4122 W 55TH PL",
"address_2": "SUITE 119",
"city": "TULSA",
"state": "OK",
"postal_code": "741079108",
"telephone_number": "918-486-9996",
"fax_number": "800-260-7966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THUNDU",
"first_name": "SOPHIA",
"middle_name": "EMMA",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-13",
"last_updated": "2014-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OK",
"license": "CANDIDATE",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NEW ENROLLMENT",
"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 Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.