Michelle Lee Gaines, MA, LBP, CCRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0089 Issued in OK

Practice address

2801 Parklawn Dr Ste 303
Midwest City, OK 73110-4230

Phone

(405) 610-3644

Fax

(405) 610-3647

NPI assigned

Nov 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Oasis Counseling Center,Inc.

  • Community/Behavioral Health Agency
  • Oklahoma City, OK
  • NPI 1679699169
  NPD
• Michelle Vernon, PLLC

  • Professional Counselor
  • Oklahoma City, OK
  • NPI 1972895357
  NPD (past)

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1013245364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 PARKLAWN DR STE 303",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104230",
            "telephone_number": "405-245-9233",
            "fax_number": "405-610-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 PARKLAWN DR STE 303",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104230",
            "telephone_number": "405-610-3644",
            "fax_number": "405-610-3647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13071 Fairway Dr",
            "address_purpose": "LOCATION",
            "city": "Choctaw",
            "state": "OK",
            "postal_code": "730208147",
            "country_code": "US",
            "telephone_number": "405-769-1613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "MA, LBP, CCRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-25",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "0089",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "0089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200330740B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Full Circle Youth and Family Services, PLLC
• Shanon M Funkhouser, COTA
• Lawanna Gage
• Deanna Gaines
• Melvin Gaines
• Diane Galindo
• Sharon Gallimore
• Katherine Ann Gamble, DMD
• Ganga M Pujari
• Angelique Garcia

• Professional Counselor in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.