Active NPI
Jonny Ray Brandon, LCSW
- Clinical Social Worker
- Norman, OK
National Provider Identifier
1982995049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4165
- Practice address
- 304 Dollina Dr
Norman, OK 73069-7570 - Phone
- (405) 488-4096
- NPI assigned
- Apr 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | OK | ||
| Clinical Social Worker | 1041C0700X | 4165 | OK | Primary |
Addresses
Primary practice location
304 Dollina Dr
Norman, OK 73069-7570
Mailing address
304 Dollina Dr
Norman, OK 73069-7570
Phone (405) 488-4096
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4165 | OK | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Journey Therapeutic Services PLLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Ada, OK
- NPI 1316385917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1982995049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 DOLLINA DR",
"city": "NORMAN",
"state": "OK",
"postal_code": "730697570",
"telephone_number": "405-488-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 DOLLINA DR",
"city": "NORMAN",
"state": "OK",
"postal_code": "730697570",
"telephone_number": "405-488-4096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDON",
"first_name": "JONNY",
"middle_name": "RAY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-25",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OK",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "4165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.