Individual provider Active NPI

Kevin Anthony Bone, MS, LPC, LADC/MH

  • Addiction (Substance Use Disorder) Counselor
  • Ardmore, OK
National Provider Identifier
1124350863
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
9 10TH Ave NW
Ardmore, OK 73401-5929
Phone
(580) 226-1656
Fax
(844) 270-7511
NPI assigned
Feb 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

9 10TH Ave NW
Ardmore, OK 73401-5929

Mailing address

9 10TH Ave NW
Ardmore, OK 73401-5929
Phone (580) 226-1656

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
I20231207002995 OK Practitioner - Mental Health Counselor 4880043488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse Behavioral Wellness CentersGroup PAC ID 6406748961, 59 clinicians

Practice addresses (Care Compare)

2530 S Commerce St
BLDG B
Ardmore, OK 73401-5519
Phone (580) 223-5636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7149OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Wellness Centers Current Accepting new patients
Arbuckle Life Solutions, Inc. Current Accepting new patients
Lighthouse Behavioral Wellness Centers CurrentSince Jan 1, 2024 Accepting new patients

Locations

2530 S Commerce St
Bldg B
Ardmore, OK 73401
Phone (580) 319-7305

9 10th Ave NW
Ardmore, OK 73401
Phone (580) 226-1656

Organizations & group practices 3

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": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1124350863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 10TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015929",
            "telephone_number": "580-226-1656",
            "fax_number": "844-270-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 10TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015929",
            "telephone_number": "580-226-1656",
            "fax_number": "844-270-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONE",
        "first_name": "KEVIN",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "MS, LPC, LADC/MH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-05",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.