Brandy Adams, MSW
Individual provider Active NPI Clinical Social Worker · Pryor, OK
NPI 1962800441 · NPPES record last updated Sep 10, 2020
Key facts
- NPI
- 1962800441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 7395 (OK)
- Practice address
- 109 N Fairland St
Pryor, OK 74361-4203 - Phone
- (918) 825-1405
- Fax
- (918) 876-3436
- NPI assigned
- Dec 15, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200916001165 | OK | Practitioner - Clinical Social Worker | 9032537469 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7395 | OK | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Lake Mental Health Center, Inc. | Current | Accepting new patients | |
| Grand Lake Mental Health Center, Inc. | Current |
Accepting new patients | |
| Grand Lake Mental Health Center, Inc. | Current |
Accepting new patients |
Locations
111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511
114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207
109 N Fairland St
Pryor, OK 74361
Phone (918) 825-1406
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7395 | OK | Yes |
Addresses
Primary practice location
109 N Fairland St
Pryor, OK 74361-4203
Mailing address
109 N Fairland St
Pryor, OK 74361-4203
Phone (918) 825-1405
Other providers in Pryor, OK
- Wendy Rachell Adams
- Hilary Nicole Admire
- Advanced Dental Solutions PS
- Ahs Pryor Hospital, LLC
- Ahs Pryor Hospital, LLC
All providers in Pryor, OK · Clinical Social Worker in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.