Active NPI
Kathleen Marie Niblack, LPC
- Counselor
- Oklahoma City, OK
National Provider Identifier
1164602033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 3442
- Practice address
- 10400 Vineyard Blvd Ste H200
Oklahoma City, OK 73120-3830 - Phone
- (405) 516-3248
- Fax
- (405) 516-3249
- NPI assigned
- Nov 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0101391 | NM | |
| Counselor | 101Y00000X | 3442 | OK | Primary |
Addresses
Primary practice location
10400 Vineyard Blvd Ste H200
Oklahoma City, OK 73120-3830
Mailing address
10400 Vineyard Blvd Ste H200
Oklahoma City, OK 73120-3830
Phone (405) 607-2995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101391 | NM | MD | Counselor |
| 3442 | OK | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559606400000",
"number": "1164602033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 VINEYARD BLVD STE H200",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731203830",
"telephone_number": "405-607-2995",
"fax_number": "405-254-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 VINEYARD BLVD STE H200",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731203830",
"telephone_number": "405-516-3248",
"fax_number": "405-516-3249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIBLACK",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-08",
"last_updated": "2019-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NM",
"license": "0101391",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OK",
"license": "3442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.