Individual provider Active NPI

Stephanie Redding

  • Marriage & Family Therapist
  • Nowata, OK
National Provider Identifier
1124230206
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1335 Issued in OK
Practice address
325 S Ash St
Nowata, OK 74048-4628
Phone
(918) 273-7344
Fax
(918) 999-0111
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LAC 1068 KS
Marriage & Family Therapist 106H00000X 640 KS
Marriage & Family Therapist 106H00000X 1335 OK Primary

Addresses

Primary practice location

325 S Ash St
Nowata, OK 74048-4628

Mailing address

325 S Ash St
Nowata, OK 74048-4628
Phone (918) 273-7344

Other identifiers 1

IdentifierTypeStateIssuer
200435840AMedicaidKS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240829001298 OK Practitioner - Marriage and Family Therapist 6608315080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC 1068KSMDAddiction (Substance Use Disorder) Counselor
1335OKMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Aug 15, 2024 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Aug 15, 2024 Accepting new patients
Four County Mental Health Center Inc Past Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

325 S Ash St
Nowata, OK 74048
Phone (918) 273-7344

Organizations & group practices 4

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1124230206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S ASH ST",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740484628",
            "telephone_number": "918-273-7344",
            "fax_number": "918-999-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S ASH ST",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740484628",
            "telephone_number": "918-273-7344",
            "fax_number": "918-999-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDING",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "LAC 1068",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "640",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "1335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200435840A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nowata, OK

Sources for this page

Verify at the official NPI Registry.