Individual provider Active NPI

Aaron Coffman

  • Addiction (Substance Use Disorder) Counselor
  • Tulsa, OK
National Provider Identifier
1083170302
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
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

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415000677 OK Practitioner - Mental Health Counselor 6608391420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1492OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 28, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 28, 2025 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.

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

Verify at the official NPI Registry.