Active NPI
Cathy Mack, LPC
- Professional Counselor
- Sallisaw, OK
National Provider Identifier
1215105556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3692
- Practice address
- 205 S JT Stites Blvd
Sallisaw, OK 74955-9301 - Phone
- (918) 775-7787
- Fax
- (918) 775-3580
- NPI assigned
- Feb 20, 2008
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3692 | OK | Primary |
Addresses
Primary practice location
205 S JT Stites Blvd
Sallisaw, OK 74955-9301
Mailing address
210 S JT Stites Blvd
Sallisaw, OK 74955-9301
Phone (918) 775-7787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200360410A | 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lequita J. Joyce Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Roland, OK
- NPI 1255491494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1215105556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 S JT STITES BLVD",
"city": "SALLISAW",
"state": "OK",
"postal_code": "749559301",
"telephone_number": "918-775-7787",
"fax_number": "918-775-0328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S JT STITES BLVD",
"city": "SALLISAW",
"state": "OK",
"postal_code": "749559301",
"telephone_number": "918-775-7787",
"fax_number": "918-775-3580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "CATHY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-20",
"last_updated": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "3692",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200360410A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sallisaw, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.