Michael Bruce Etzler

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1218 E 9TH St Ste 4
Edmond, OK 73034-5796

Phone

(405) 476-5826

NPI assigned

Jan 15, 2013

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1104163773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 SPRING HILL DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136929",
            "telephone_number": "405-476-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 E 9TH ST STE 4",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345796",
            "telephone_number": "405-476-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETZLER",
        "first_name": "MICHAEL",
        "middle_name": "BRUCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-15",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blaire Allyn Ersteniuk, DDS MS
• Gabriela Escobar
• Janet Lee Eskridge, RPT
• Monica Esparza, ARNP, DNP
• Jacqueline Espindola
• Craig Randall Evans, MD
• Emma Evans
• Kathryn Nicole Evans, DC
• Kelli J Evans
• Robert Evans Jr., M.ED

• Mental Health Counselor in Edmond, OK
• Providers in Edmond, 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 Aug 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.