Individual provider Active NPI

Danette Lyn Kirk, LPC

  • Mental Health Counselor
  • Norman, OK
National Provider Identifier
1083380471
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11139 Issued in OK
Practice address
1120 E Main St
Norman, OK 73071-5300
Phone
(405) 360-5100
NPI assigned
Aug 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 11139 OK Primary

Addresses

Primary practice location

1120 E Main St
Norman, OK 73071-5300

Mailing address

3607 Jubilee St
Norman, OK 73072-1959
Phone (405) 313-7956

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

LicenseStateTypeSpecialty
11139OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
State of Oklahoma CurrentSince Jun 23, 2024 Accepting new patients
Restore Behavioral Health LLC Mental Health Past Accepting new patients
Integrated Therapy Solutions of Oklahoma, LLC PastSince Oct 3, 2022 Accepting new patients

Locations

1120 E Main St
Norman, OK 73071
Phone (405) 573-3518

Organizations & group practices 3

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1083380471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 JUBILEE ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730721959",
            "telephone_number": "405-313-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715300",
            "telephone_number": "405-360-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "DANETTE",
        "middle_name": "LYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "11139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.