Active NPI
Kirk Michael Hollis, LPC
- Professional Counselor
- Ponca City, OK
National Provider Identifier
1003957218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1900
- Practice address
- 111 W Grand Ave
Ponca City, OK 74601-5211 - Phone
- (580) 767-8000
- NPI assigned
- Feb 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1900 | OK | Primary |
Addresses
Primary practice location
111 W Grand Ave
Ponca City, OK 74601-5211
Mailing address
3000 Larchmont Ave
Ponca City, OK 74604-4431
Phone (580) 765-8516
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1900 | OK | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ponca City Public School | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Ponca City, OK
- NPI 1770655839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003957218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 LARCHMONT AVE",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746044431",
"telephone_number": "580-765-8516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W GRAND AVE",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746015211",
"telephone_number": "580-767-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIS",
"first_name": "KIRK",
"middle_name": "MICHAEL",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "1900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponca City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.