JENNIFER LUCAS BRUSICH (NPI# 1790157394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790157394 |
| Entity Type | Individual |
| Full Name | JENNIFER LUCAS BRUSICH |
| Credential | PSY.D. |
| Practice Address |
5212 E 69th Pl Tulsa OK 74136-3407 |
| Practice Telephone | 9182800101 |
| Mailing Telephone | 9182800101 |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2019-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
1246 | OK | Behavioral Health & Social Service Providers |
| Street Address |
5212 E 69TH PL |
| City | TULSA |
| State | OK |
| Zip Code | 74136-3407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912520883 | Esmeralda Rosales | Behavior Technician | 7306 S. Yale Ave, Tulsa, OK 74136 | 2020-05-26 |
| 1851939631 | Kenneth Aaron Pohl | Behavior Technician | 7107 S. Braden Ave. Suite 195, Tulsa, OK 74136 | 2019-12-12 |
| 1578109195 | Brett Ray Weaver | Chiropractor | Kelly Bldg Ste 106, 6565 S Yale Ave, Tulsa, OK 74136 | 2019-11-19 |
| 1477194488 | Adhd and Mood Center of Oklahoma | Clinic/Center | 6565 South Yale Ave, Suite 706, Tulsa, OK 74136 | 2019-10-01 |
| 1093272510 | Whitney Christine Pilkenton | Registered Nurse | 6161 S. Yale Ave., Tulsa, OK 74136 | 2019-02-21 |
| 1538639190 | Osu Center for Health Sciences | Clinic/Center | 6465 S. Yale Ave. Suite 514, Tulsa, OK 74136 | 2018-11-27 |
| 1043786304 | Saint Francis Hospital, Inc. | Hospice Care, Community Based | 6600 South Yale Ave Suite 350, Tulsa, OK 74136 | 2018-10-15 |
| 1891282877 | Premier Rheumatology of Oklahoma | Internal Medicine | 6114 E. 61st Street, Tulsa, OK 74136 | 2018-04-16 |
| 1679092175 | Grace Eloise Evans | Counselor | 6655 S. Yale Ave, Tulsa, OK 74136 | 2017-09-15 |
| 1598283756 | David Oladipo Abioye | Counselor | 7110 S Utica Avenue, Suite 613, Tulsa, OK 74136 | 2017-09-07 |
| Find all providers in zip 74136 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144611336 | Kelly Davis | Psychologist | 9525 S 93rd East Ave, Tulsa, OK 74133-6160 | 2015-02-10 |
| 1730505645 | Christine Wayman | Psychologist | 1516 S Boston Ave, Suite 1, Tulsa, OK 74119-4003 | 2014-03-16 |
| 1588936512 | Sarah Alison Jones | Psychologist | 5110 S Yale Ave, Suite 103, Tulsa, OK 74135-7401 | 2012-02-07 |
| 1295007508 | Christopher Daniel Hogue | Psychologist | 5110 S Yale Ave, Suite 103, Tulsa, OK 74135-7401 | 2012-02-01 |
| 1215209606 | Edith A. Lamay | Psychologist | 5110 S Yale Ave, Ste 103, Tulsa, OK 74135-7401 | 2012-02-01 |
| 1518251206 | Megan R Brown Harris | Psychologist | 7501 Riverside Pkwy, Tulsa, OK 74136-5056 | 2011-05-31 |
| 1568632776 | Tulsa Center for Child Psychology Pllc | Psychologist | 5110 S Yale Ave, Ste 103, Tulsa, OK 74135-7401 | 2008-03-04 |
| 1790969004 | Pommetha Mcgill | Psychologist | 7010 S Yale Ave, Suite 215, Tulsa, OK 74136-5713 | 2007-12-21 |
| 1619904448 | Richarad Allyn Walton Jr. | Psychologist | 5110 S Yale Ave, Suite 103, Tulsa, OK 74135-7401 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497111082 | Suzanne Huffman | Psychologist | 601 Vista Ln Trlr 88, Edmond, OK 73034-6329 | 2016-01-12 |
| 1558797589 | Blanca A Correa | Psychologist | 344139 E 740 Rd, Agra, OK 74824-8434 | 2013-09-23 |
| 1932546520 | Christina Dawn Willey | Psychologist | 8221 N 117th East Ave, Owasso, OK 74055-2603 | 2013-05-23 |
| 1841423845 | Anne Katherine Jacobs | Psychologist | 515 S Santa Fe Ave, Suite 106, Edmond, OK 73003-6210 | 2009-08-25 |
| 1306016118 | Diane Janice Willis | Psychologist | 4520 Ridgeline Dr, Norman, OK 73072-1729 | 2008-03-07 |
| 1821199217 | Marguerita Lynn Cagle | Psychologist | 10901 E 76th St N, Owasso, OK 74055-3631 | 2006-09-26 |
| 1003856741 | Kelly J Griffith | Psychologist | 1024 W Lakeridge Ave, Stillwater, OK 74075-2106 | 2006-06-08 |
| 1063056737 | Daniel Lawrence Gering | Psychologist | 1212 S Air Depot Blvd Ste 17, Midwest City, OK 73110-4860 | 2019-11-05 |
| 1639645708 | Elena M. Doskey | Psychologist | 1100 Ne 13th St, Oklahoma City, OK 73117-1039 | 2018-10-16 |
| 1972097228 | Allison Vrieze | Psychologist | 1044 Sw 4th St, Moore, OK 73160-2405 | 2018-06-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.