Active NPI
Jaylene Lander, LBP
- Mental Health Counselor
- Lawton, OK
National Provider Identifier
1063509602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0077
- Practice address
- 1719 SW 11TH St
Lawton, OK 73501-7305 - Phone
- (580) 581-1818
- Fax
- (580) 581-1819
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0077 | OK | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 398 | OK |
Addresses
Primary practice location
1719 SW 11TH St
Lawton, OK 73501-7305
Mailing address
PO Box 662
Purcell, OK 73080-0662
Phone (405) 527-1785
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 |
|---|---|---|---|
| 398 | OK | MD | Addiction (Substance Use Disorder) Counselor |
| 0077 | OK | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305158400000",
"number": "1063509602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 662",
"city": "PURCELL",
"state": "OK",
"postal_code": "730800662",
"telephone_number": "405-527-1785",
"fax_number": "405-527-1084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1719 SW 11TH ST",
"city": "LAWTON",
"state": "OK",
"postal_code": "735017305",
"telephone_number": "580-581-1818",
"fax_number": "580-581-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDER",
"first_name": "JAYLENE",
"credential": "LBP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2011-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "0077",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OK",
"license": "398",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.