Active NPI
Lisa Diane Trickett, MS, LPC-US
- Mental Health Counselor
- Stigler, OK
National Provider Identifier
1205167707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 904 NW 4TH St
Stigler, OK 74462 - Phone
- (918) 967-8223
- Fax
- (918) 967-8203
- NPI assigned
- Jan 22, 2010
- Last updated
- Jul 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
904 NW 4TH St
Stigler, OK 74462
Mailing address
904 NW 4TH St
Stigler, OK 74462-1653
Phone (918) 967-8223
Other practice location 1
301 E Main St
Suite 3
Wilburton, OK 74578-4415
Phone (918) 465-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100746580A | Medicaid | OK |
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Homebased Services and Resources | Past | Accepting new patients | |
| Eastern Sky Mental Health, Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Wilburton, OK
- NPI 1871887703
-
- Community/Behavioral Health Agency
- Stigler, OK
- NPI 1386079648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562889600000",
"number": "1205167707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 NW 4TH ST",
"city": "STIGLER",
"state": "OK",
"postal_code": "744621653",
"telephone_number": "918-967-8223",
"fax_number": "918-967-8203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 NW 4TH ST",
"city": "STIGLER",
"state": "OK",
"postal_code": "74462",
"telephone_number": "918-967-8223",
"fax_number": "918-967-8203"
}
],
"practiceLocations": [
{
"address_1": "301 E Main St",
"address_2": "Suite 3",
"address_purpose": "LOCATION",
"city": "Wilburton",
"state": "OK",
"postal_code": "745784415",
"country_code": "US",
"telephone_number": "918-465-0300",
"fax_number": "918-465-0300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRICKETT",
"first_name": "LISA",
"middle_name": "DIANE",
"name_prefix": "Miss",
"credential": "MS, LPC-US",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-22",
"last_updated": "2019-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100746580A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stigler, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.