Individual provider Active NPI

Stacy Lee Gibbs, LPC

  • Professional Counselor
  • Broken Arrow, OK
National Provider Identifier
1194996199
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6231 Issued in OK
Practice address
3300 S Aspen Ave Ste D
Broken Arrow, OK 74012-7501
Phone
(918) 973-1464
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 6909 NC
Professional Counselor 101YP2500X 6231 OK Primary

Addresses

Primary practice location

3300 S Aspen Ave Ste D
Broken Arrow, OK 74012-7501

Mailing address

3300 S Aspen Ave Ste D
Broken Arrow, OK 74012-7501
Phone (918) 974-1464

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
I20240306002440 OK Practitioner - Mental Health Counselor 9032525159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choose Courage Counseling Services, PLLCGroup PAC ID 3577936863, 5 clinicians

Practice addresses (Care Compare)

3300 S Aspen Ave
Suite D
Broken Arrow, OK 74012-7501
Phone (918) 940-7158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6909NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Choose Courage Counseling Services PLLC CurrentSince Sep 1, 2021 Accepting new patients
Kidzcare Pediatrics, PC Past Accepting new patients

Locations

3300 S Aspen Ave
Ste D
Broken Arrow, OK 74012
Phone (918) 451-2020

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CreeksideGrundy Center, IA, CCN 165623 Skilled nursing facility Operational/Managerial Control Feb 26, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1194996199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S ASPEN AVE STE D",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127501",
            "telephone_number": "918-974-1464",
            "fax_number": "910-424-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S ASPEN AVE STE D",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127501",
            "telephone_number": "918-973-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "STACY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "6909",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "6231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.