BROKEN ARROW PUBLIC SCHOOLS
NPI 1669580502
Psychologist in Broken Arrow, OK

Active since August 29, 2006CLIA 37D2324383 · Waiver
112 N MAIN ST, BROKEN ARROW, OK 74012(918) 259-4540(918) 258-0958 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Broken Arrow Public Schools NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROKEN ARROW PUBLIC SCHOOLS (NPI 1669580502) is a healthcare organization registered as a psychologist in Broken Arrow, Oklahoma and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through May 21, 2027 and lists Jamie Gilroy, Medicaid Coordinator, as its authorized official.

NPPES Registry Identity

NPI1669580502
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameBROKEN ARROW PUBLIC SCHOOLS
Location Address112 N MAIN STBroken Arrow, OK 74012-3937
Mailing Address112 N Main StBroken Arrow, OK 74012-3937 · (918) 259-4540 · Fax (918) 258-0958
Fax(918) 258-0958
Organization SubpartNo
Authorized OfficialJamie GilroyMedicaid Coordinator · (918) 259-4540
Enumeration DateAugust 29, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPI 1669580502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedOccupational Therapy AssistantTaxonomy 224Z00000X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
112 N MAIN ST, Broken Arrow, OK 74012

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2324383

Broken Arrow Public Schools · Broken Arrow, OK
Active · expires May 21, 2027
CLIA Number37D2324383
Laboratory TypeSchool/Student Health Service
Certificate Effective DateMay 22, 2025
Certificate Expiration DateMay 21, 2027
Laboratory DirectorDerek Blackburn
Laboratory Phone(918) 259-5700
Laboratory LocationBroken Arrow Public Schools701 S Main Street, Broken Arrow, OK 74012
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Peer Specialist
112 N MAIN ST
BROKEN ARROW, OK 74012

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broken Arrow Public Schools's NPI number?

The NPI number for Broken Arrow Public Schools is 1669580502. It was assigned to this organization in the NPPES registry on August 29, 2006.

Where is Broken Arrow Public Schools located?

Broken Arrow Public Schools is located at 112 N Main St, Broken Arrow, OK 74012. The listed phone number is (918) 259-4540.

What is Broken Arrow Public Schools's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Does Broken Arrow Public Schools hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2324383) is associated with this NPI, valid through May 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Broken Arrow Public Schools was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.