Individual provider Active NPI

Melinda Clinton

  • Clinical Social Worker
  • Jonesboro, LA
National Provider Identifier
1962914002
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7224 Issued in OK
Practice address
525 Alexander St
Jonesboro, LA 71251-2001
Phone
(318) 459-6795
NPI assigned
Oct 30, 2017
Last updated
Jan 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X 7224 OK
Clinical Social Worker 1041C0700X 7224 OK Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

525 Alexander St
Jonesboro, LA 71251-2001

Mailing address

1000 Chinaberry Dr Ste 903
Bossier City, LA 71111-2455
Phone (318) 459-6795

Other practice location 1

297 Fox Run Cir
Jenks, OK 74037-9510
Phone (918) 946-5823

Other practice location 2

3015 E Skelly Dr Ste 103
Tulsa, OK 74105-6344
Phone (918) 712-0859

Other identifiers 1

IdentifierTypeStateIssuer
200323940MedicaidOK

Other names 1

  • Melinda A Clinton Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210607003231 OK Practitioner - Clinical Social Worker 9638579097 Reassigns benefits to 2 organizations
I20241119002775 LA Practitioner - Clinical Social Worker 9638579097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7224OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Mental Health, LLC Counselor CurrentSince Sep 30, 2024 Accepting new patients
Miss-Lou Addiction Clinic Case Manager/Care Coordinator CurrentSince Jan 21, 2022 Accepting new patients
Shortgrass Community Health Center, Inc CurrentSince Jul 1, 2024 Accepting new patients
Alliance Mental Health, LLC Mental Health CurrentSince Sep 30, 2024 Accepting new patients
Finding Perspective, LLC Clinical CurrentSince Nov 4, 2024 Accepting new patients
Shortgrass Community Health Center, Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

1000 Chinaberry Dr
Ste 903
Bossier City, LA 71111
Phone (318) 455-3915

525 Alexander St
Jonesboro, LA 71251
Phone (318) 259-4676

101 S Hudson St
Altus, OK 73521
Phone (580) 301-6154

1402 N Florence Ave
Ste B
Claremore, OK 74017
Phone 9186080380716

400 E Sycamore St
Hollis, OK 73550
Phone (580) 688-2800

8988 S Sheridan Rd
Ste D2
Tulsa, OK 74133
Phone (970) 834-8610

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1962914002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CHINABERRY DR STE 903",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112455",
            "telephone_number": "318-459-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ALEXANDER ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712512001",
            "telephone_number": "318-459-6795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "297 Fox Run Cir",
            "address_purpose": "LOCATION",
            "city": "Jenks",
            "state": "OK",
            "postal_code": "740379510",
            "country_code": "US",
            "telephone_number": "918-946-5823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3015 E Skelly Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741056344",
            "country_code": "US",
            "telephone_number": "918-712-0859",
            "fax_number": "918-388-9708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "MELINDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "7224",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "7224",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200323940",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "CLINTON",
            "middle_name": "A",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jonesboro, LA

Sources for this page

Verify at the official NPI Registry.