AUDREY KATHERINE BRYAN (LCSW) – Clinical Social Worker, NPI 1235319864

AUDREY KATHERINE BRYAN (LCSW) is a healthcare provider. based in Tulsa, Oklahoma. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 1696 (OK). The NPI Number for AUDREY KATHERINE BRYAN (LCSW) is 1235319864

Main info

Female
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
AUDREY KATHERINE BRYAN (LCSW)
NPI
1235319864
Phone
(918) 582-2131
Address
1620 E 12TH ST
Enumeration Date
12 November 2007
Last Update Date
12 November 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9185822131
Graduation Year
1990 (36 years ago)
PAC ID
0042563025
Group Practice PAC ID
5496644049
Professional Enrollment ID
I20181020000151
Address ID
OK741205407TU1620XSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

628 CLINICAL SOCIAL WORKER in OK

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Provider Addresses for AUDREY KATHERINE BRYAN (LCSW)

  • 1620, East 12th Street, Forest Orchard, Tulsa, Tulsa County, Oklahoma, 74120, United States

    TULSA, OK 741205407

    Phone: (918) 582-2131

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-10-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181020000151IClinical Social WorkerOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes12021$0
90791Psychiatric diagnostic evaluation1414$0
View full utilization report →

Insurance plans in this area (ZIP 74120)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496644049View full group profile
NameSpecialtyState
-OK
-OK
Nurse PractitionerOK
P S Y C H I A T R YOK
Mental Health CounselorOK
Clinical Social WorkerOK
P S Y C H I A T R YOK
Nurse PractitionerOK
Clinical Social WorkerOK
Clinical Social WorkerOK

Reviews

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Frequently asked questions

What unique ID ties claims to AUDREY KATHERINE BRYAN (LCSW)?
NPI 1235319864 is assigned to AUDREY KATHERINE BRYAN (LCSW) under the national enumeration system.
Is AUDREY KATHERINE BRYAN (LCSW) currently active in the NPI registry?
CMS-published data lists AUDREY KATHERINE BRYAN (LCSW) as an active registrant.
Does AUDREY KATHERINE BRYAN (LCSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for AUDREY KATHERINE BRYAN (LCSW). Clinical services aligned with this taxonomy classification.
Where is AUDREY KATHERINE BRYAN (LCSW)'s primary listing?
We display Tulsa, Oklahoma because that is what the record indicates for AUDREY KATHERINE BRYAN (LCSW).
Is AUDREY KATHERINE BRYAN (LCSW) a real provider?
This page reflects official NPPES data for NPI 1235319864. Always confirm identity and privileges with the practice and licensing boards.

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