1. Home
  2. Directory
  3. Oklahoma
  4. Tulsa
  5. Community Behavioral Health
  6. NPI Profile
  7. NPI Record 1538634654

PREVAILING PASSIONS COUNSELING
Complete NPI Record 1538634654
Community/Behavioral Health in Tulsa, OK

NPI Status: Active since October 04, 2018

Contact Information

10212 E 41ST ST
TULSA, OK
ZIP 74146
Phone: (918) 970-0028

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Authorized Official Last Name
  20. Authorized Official First Name
  21. Authorized Official Title or Position
  22. Authorized Official Telephone Number
  23. Healthcare Provider Taxonomy Code 1
  24. Healthcare Provider Primary Taxonomy Switch 1
  25. Healthcare Provider Taxonomy Code 2
  26. Healthcare Provider Primary Taxonomy Switch 2
  27. Is Organization Subpart
  28. Authorized Official Name Prefix Text
  29. Authorized Official Credential Text
  30. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1538634654. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1538634654
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 11841 E 16TH ST
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Business Mailing Address City Name: TULSA
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: OK
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Postal Code: 741285805
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Telephone Number: 4792831016
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 10212 E 41ST ST
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address City Name: TULSA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: OK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 741463703
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number: 9189700028
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/4/2018
The telephone number associated with the location address of the provider being identified.
Last Update Date: 10/14/2019
The date that a record was last updated or changed.
Authorized Official Last Name: WOODBURY
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: DERRICK
The first name of the authorized official.
Authorized Official Title or Position: OWNER
The first name of the authorized official.
Authorized Official Telephone Number: 4792831016
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 101YP2500X
The 10-position telephone number of the authorized official.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 251S00000X
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: MR.
Authorized Official Credential Text: LPC
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP