Individual provider Active NPI

Keesha Leigh Kuntz, LPC #4250

  • Professional Counselor
  • Bartlesville, OK
National Provider Identifier
1013153824
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC#4250 Issued in OK
Practice address
417 E Silas St
Bartlesville, OK 74003
Phone
(918) 337-6050
Fax
(918) 337-6061
NPI assigned
Dec 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X LPC#4250 OK Primary

Addresses

Primary practice location

417 E Silas St
Bartlesville, OK 74003

Mailing address

417 E Silas St
Bartlesville, OK 74003
Phone (918) 337-6050

Other identifiers 1

IdentifierTypeStateIssuer
200316290AMedicaidOK

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

LicenseStateTypeSpecialty
LPC#4250OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Psychological Associates PLLC PastSince Jan 21, 2021 Accepting new patients
Wilson Psychological Assessments, PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1013153824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E SILAS ST",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74003",
            "telephone_number": "918-337-6050",
            "fax_number": "918-337-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 E SILAS ST",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74003",
            "telephone_number": "918-337-6050",
            "fax_number": "918-337-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZ",
        "first_name": "KEESHA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "LPC #4250",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-29",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "LPC#4250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200316290A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.