Kelly Bender, LPC
Individual provider Active NPI Mental Health Counselor · Moore, OK
NPI 1174623201 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174623201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 3204 (OK)
- Practice address
- 1922 N Eastern Ave
Moore, OK 73160-5605 - Phone
- (405) 325-8945
- Fax
- (405) 735-5265
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3204 | OK | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mariposa Counseling, Inc. | Mental Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3204 | OK | Yes |
Addresses
Primary practice location
1922 N Eastern Ave
Moore, OK 73160-5605
Mailing address
1624 Creekside LN
Norman, OK 73071-1306
Phone (405) 326-8945
Other providers in Moore, OK
- Whitney Dawn Bell
- Bellecrest Homes LLC
- Bellecrest LLC
- Charles Bender
- Kalin Bender
- Brandon Lee Benear
- Molly Berg
- Paige Bickel
- Sherree Biermann
- Makhia E'Lay Bills
All providers in Moore, OK · Mental Health Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.