Jamie Dawn Phillips, MS, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2685 Issued in OK

Practice address

407 W South Ave
Ponca City, OK 74601-6133

Phone

(918) 549-8404

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Lake Mental Health Center, Inc.

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520
  Medicare reassignment
• Grand Lake Mental Health Center Inc

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawhuska, OK
  • NPI 1457993834
  NPD
• Grand Lake Mental Health Center, Inc.

  dba Grand Mental Health

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1093854556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W SOUTH AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746016133",
            "telephone_number": "580-749-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W SOUTH AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746016133",
            "telephone_number": "918-549-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JAMIE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "2685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramona Estrada Peralez, RPT
• Randall Quirt Perkins, PHARM-D
• Brenda Lee Peters, A.R.N.P. & C.P.N.P.
• Phillip a. Tyndall, DDS, PC
• Phillip a. Tyndall, DDS,PC
• Physicians Urgent Care Center, Inc.
• Amie Elaine Pickard, MCP
• Paul Bradley Plowman, M.D.
• Pamela J Poland, M.D.
• Ponca City Dental Group PLLC

• Mental Health Counselor in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.