Organization Active NPI

M. Rachelle Hardin-Moniz,L.C.S.W.,P.C.

  • Clinical Social Worker
  • Norman, OK
National Provider Identifier
1972790780
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1025 Issued in OK
Legal business name
M. RACHELLE HARDIN-MONIZ,L.C.S.W.,P.C.
Practice address
2420 Springer Dr
Suite 215
Norman, OK 73069-3965
Phone
(405) 366-6068
Fax
(405) 366-6281
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Authorized official

Name
Mrs. Martha Rachelle Hardin-Moniz, L.C.S.W.
Title
President
Phone
(405) 366-6068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 1025 OK Primary

Addresses

Primary practice location

2420 Springer Dr
Suite 215
Norman, OK 73069-3965

Mailing address

PO Box 5423
Norman, OK 73070-5423
Phone (405) 366-6068

Other identifiers 1

IdentifierTypeStateIssuer
200105400AMedicaidOK

Other names 1

  • n/a Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050506000392 OK Part B Supplier - Clinic/Group Practice 7618921719 Practice locations: Norman, OK

National Provider Directory

National Provider Directory

Locations

2420 Springer Dr
Ste 215
Norman, OK 73069
Phone (405) 366-6068

1800 N Interstate Dr
Ste 107
Norman, OK 73072
Phone (405) 290-1484

1800 N Interstate Dr
Ste 127
Norman, OK 73072
Phone (405) 290-1484

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1972790780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5423",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730705423",
            "telephone_number": "405-366-6068",
            "fax_number": "405-366-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 SPRINGER DR",
            "address_2": "SUITE 215",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730693965",
            "telephone_number": "405-366-6068",
            "fax_number": "405-366-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. RACHELLE HARDIN-MONIZ,L.C.S.W.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "HARDIN-MONIZ",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "RACHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-366-6068",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "1025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200105400A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.