Individual provider Active NPI

Katherine Ann Wilson, MA

  • Mental Health Counselor
  • Bartlesville, OK
National Provider Identifier
1063170454
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
700 SW Penn
Bartlesville, OK 74003-3847
Phone
(918) 402-0811
NPI assigned
Dec 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

700 SW Penn
Bartlesville, OK 74003-3847

Mailing address

700 SW Penn
Bartlesville, OK 74003-3847
Phone (918) 337-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402003546 OK Practitioner - Mental Health Counselor 6608399340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 31, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 31, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Wilson Psychological Assessments, PLLC PastSince Dec 1, 2021 Accepting new patients
Wilson Psychological Associates PLLC PastSince Dec 1, 2021 Accepting new patients

Locations

700 S Penn Ave
Bartlesville, OK 74003
Phone (918) 337-8099

705 S Virginia Ave
Bartlesville, OK 74003
Phone (918) 231-0810

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

Organizations & group practices 5

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": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1063170454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SW PENN",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033847",
            "telephone_number": "918-337-8080",
            "fax_number": "918-337-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW PENN",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033847",
            "telephone_number": "918-402-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2022-04-06",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.