Active NPI
Aaron Coffman
- Addiction (Substance Use Disorder) Counselor
- Tulsa, OK
National Provider Identifier
1083170302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 6333 E Skelly Dr
Tulsa, OK 74135-6106 - Phone
- (918) 605-4170
- NPI assigned
- Feb 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
6333 E Skelly Dr
Tulsa, OK 74135-6106
Mailing address
6333 E Skelly Dr
Tulsa, OK 74135-6106
Phone (918) 605-4170
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1492 | OK | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Lake Mental Health Center, Inc. | Current | Accepting new patients | |
| Grand Lake Mental Health Center, Inc. | Current | Accepting new patients | |
| Grand Lake Mental Health Center, Inc. | Current | Accepting new patients | |
| Actionsteps Counseling, Inc. | Past | Accepting new patients |
Locations
111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511
114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207
6128 E 38th St
Tulsa, OK 74135
Phone (800) 722-3611
6333 E Skelly Dr
Tulsa, OK 74135
Phone (918) 664-4224
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Miami, OK
- NPI 1497762520
-
- Community/Behavioral Health Agency
- Tulsa, OK
- NPI 1356048656
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Nowata, OK
- NPI 1467460931
-
- Community/Behavioral Health Agency
- Tulsa, OK
- NPI 1790018562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1083170302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6333 E SKELLY DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741356106",
"telephone_number": "918-605-4170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6333 E SKELLY DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741356106",
"telephone_number": "918-605-4170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFMAN",
"first_name": "AARON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-11",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.