Brenda S Bause, LPC

Individual provider Active NPI Mental Health Counselor · Ardmore, OK

NPI 1083632004 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1083632004
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
2337 (OK)
Practice address
27B South West
Suite 100 & 200
Ardmore, OK 73401
Phone
(918) 712-0859
Fax
(918) 388-6456
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2337OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Pathways Unlimited Inc Current
since Jan 1, 2024
Accepting new patients

Locations

4045 NW 64th St
Ste 520
Oklahoma City, OK 73116
Phone (405) 685-4791

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2337 OK Yes

Addresses

Primary practice location

27B South West
Suite 100 & 200
Ardmore, OK 73401

Mailing address

PO Box 722
Ada, OK 74821-0722
Phone (405) 210-1110

Other providers in Ardmore, OK

All providers in Ardmore, OK · Mental Health Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.