Individual provider Active NPI

Melissa L Earnest, M.A.

  • Marriage & Family Therapist
  • Tulsa, OK
National Provider Identifier
1972804334
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1516 S Boston Ave Ste 1
Tulsa, OK 74119-4029
Phone
(918) 561-6000
NPI assigned
Nov 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1516 S Boston Ave Ste 1
Tulsa, OK 74119-4029

Mailing address

12919 E 36TH St
Tulsa, OK 74134-5001
Phone (309) 716-6303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240425000690 IL Practitioner - Marriage and Family Therapist 7618317595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southpark Psychology LTDGroup PAC ID 8527203090, 21 clinicians

Practice addresses (Care Compare)

2200 52ND Ave
Moline, IL 61265-6308
Phone (309) 797-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Cardiovascular Consultants,SC CurrentSince Jan 27, 2024 Accepting new patients
Southpark Psychology LTD CurrentSince Jan 27, 2024 Accepting new patients

Locations

2100 52nd Ave
Moline, IL 61265
Phone (309) 797-2900

2200 52nd Ave
Moline, IL 61265
Phone (309) 788-7522

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1972804334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12919 E 36TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741345001",
            "telephone_number": "309-716-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 S BOSTON AVE STE 1",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741194029",
            "telephone_number": "918-561-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARNEST",
        "first_name": "MELISSA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.