Active NPI
Nercissa E Newberry, LPC
- Counselor
- Edmond, OK
National Provider Identifier
1083215586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 10787
- Practice address
- 1721 W 33Rd St Ste B
Edmond, OK 73013-3834 - Phone
- (405) 513-3382
- NPI assigned
- Nov 3, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Counselor | 101Y00000X | 10787 | OK | Primary |
Addresses
Primary practice location
1721 W 33Rd St Ste B
Edmond, OK 73013-3834
Mailing address
1604 NW 179TH Ter
Edmond, OK 73012-4182
Phone (405) 923-2806
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 |
|---|---|---|---|
| 10787 | OK | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1083215586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1604 NW 179TH TER",
"city": "EDMOND",
"state": "OK",
"postal_code": "730124182",
"telephone_number": "405-923-2806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 W 33RD ST STE B",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133834",
"telephone_number": "405-513-3382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBERRY",
"first_name": "NERCISSA",
"middle_name": "E",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-03",
"last_updated": "2022-07-12",
"certification_date": "2022-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OK",
"license": "10787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
- New Day Youth and Family Services Inc
- New Horizon Youth & Family Services, LLC
- New Image Dentistry, PC
- New Spine Chiropractic & Acupuncture PLLC
- New Spine Injury Care PLLC
- Addison Paige Newcomb, M.A., CCC-SLP
- Anjelica Newcomer, AGAC-APRN
- Kelsey Jaden Newlun
- Crescentia Newman, PHARMD
- Scott D Newton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.