Individual provider Active NPI

Syita Tarre Rodriguez-Blash, LMFTA

  • Marriage & Family Therapist
  • Oklahoma City, OK
National Provider Identifier
1982244505
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
203572 Issued in TX
Practice address
11901 N Macarthur Blvd Ste D3
Oklahoma City, OK 73162-1855
Phone
(405) 492-7576
NPI assigned
Jan 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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 203572 TX Primary

Addresses

Primary practice location

11901 N Macarthur Blvd Ste D3
Oklahoma City, OK 73162-1855

Mailing address

1316 NW 171St St
Edmond, OK 73012-7420
Phone (316) 214-8773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240715001509 OK Practitioner - Marriage and Family Therapist 5395280374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11879OKMDPharmacist
203572TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1578700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1982244505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 NW 171ST ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127420",
            "telephone_number": "316-214-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 N MACARTHUR BLVD STE D3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731621855",
            "telephone_number": "405-492-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-BLASH",
        "first_name": "SYITA",
        "middle_name": "TARRE",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-11",
        "last_updated": "2024-06-14",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "203572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.