Mark Cody Banta, LPC
Individual provider Active NPI Mental Health Counselor · McLoud, OK
NPI 1013138965 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1013138965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 04525 (OK)
- Practice address
- 105365 S.Hwy 102
McLoud, OK 74851 - Phone
- (405) 988-2618
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231221001690 | OK | Order and Referring Only - Mental Health Counselor | 4284084922 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 04525 | OK | Yes |
Addresses
Primary practice location
105365 S.Hwy 102
McLoud, OK 74851
Mailing address
43925 Hunters Hill Dr
Shawnee, OK 74801-8927
Phone (405) 988-2075
Other providers in McLoud, OK
- Jennifer Gayle Allen
- Masumah A Amil
- Sara Arnold
- Jeremy McCandor Arrisontz
- Melissa Dawn Barnes
- Sarah Elizabeth Becker
- Amy Bowen
- Rhonda Jo Bowen
- Jeniece Ann Bridgforth
All providers in McLoud, OK · Mental Health Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.