Marla Bronson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1457 Issued in OK

Practice address

1300 Hoppe Blvd.
Suite 5
Ada, OK 74820

Phone

(580) 436-1222

Fax

(580) 436-1333

NPI assigned

Sep 30, 2015

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Lighthouse Behavioral Wellness Centers

  • Community/Behavioral Health Agency
  • Ardmore, OK
  • NPI 1518997097
  Medicare reassignment NPD
• Lighthouse Behavioral Wellness Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ardmore, OK
  • NPI 1881884807
  NPD

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1104296334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E. MAIN",
            "address_2": "RESOURCE MANAGEMENT",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-436-7211",
            "fax_number": "580-272-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOPPE BLVD.",
            "address_2": "SUITE 5",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-436-1222",
            "fax_number": "580-436-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONSON",
        "first_name": "MARLA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "1457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacie Brockhoff, B.H.R.S.
• Broderick Enterprises, LLC
• Zack Langdon Broderick, PHARMD
• Christina A Brogdon
• Tangra Lea Broge, MD
• Britney Brooks-Teel
• Jessica Dawn Brooks, B.S.
• Bradley Brown, PA
• Carla Brown
• Cyndall Leanne Brown, NAVIGATOR

• Professional Counselor in Ada, OK
• Providers in Ada, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.