Active NPI
Vondy C Fletcher, MS, LCPC
- Professional Counselor
- Broken Arrow, OK
National Provider Identifier
1992205140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10010
- Practice address
- 504 W Atlanta St
Broken Arrow, OK 74012-7004 - Phone
- (702) 907-0741
- Fax
- (539) 367-5088
- NPI assigned
- Feb 14, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | CI0334 | NV | |
| Professional Counselor | 101YP2500X | 10010 | OK | Primary |
| Behavior Analyst | 103K00000X | CP1269 | NV |
Addresses
Primary practice location
504 W Atlanta St
Broken Arrow, OK 74012-7004
Mailing address
2720 N 16TH St
Broken Arrow, OK 74012-2860
Phone (702) 907-0741
Other practice location 1
9402 W Lake Mead Blvd
Las Vegas, NV 89134-8312
Phone (702) 907-0741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145600645 | Medicaid | NV |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10010 | OK | MD | Professional Counselor |
| CI0334 | NV | MD | Behavioral Analyst |
| CP1269 | NV | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628812800000",
"number": "1992205140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2720 N 16TH ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740122860",
"telephone_number": "702-907-0741",
"fax_number": "539-367-5088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 W ATLANTA ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740127004",
"telephone_number": "702-907-0741",
"fax_number": "539-367-5088"
}
],
"practiceLocations": [
{
"address_1": "9402 W Lake Mead Blvd",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891348312",
"country_code": "US",
"telephone_number": "702-907-0741",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FLETCHER",
"first_name": "VONDY",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "MS, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-14",
"last_updated": "2021-08-13",
"certification_date": "2021-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": "NV",
"license": "CI0334",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "10010",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "CP1269",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145600645",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.