Mary Katherine Medeck, M.S., L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1250 Issued in OK

Practice address

5512 S Lewis Ave
Tulsa, OK 74105-7140

Phone

(918) 747-1600

Fax

(918) 749-2774

NPI assigned

Aug 20, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Behavioral Health Inc.

  • Psychologist
  • Tulsa, OK
  • NPI 1891911905
  NPD (past)
• River Parks Developmental Center

  • Psychologist
  • Tulsa, OK
  • NPI 1124187992
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1225260433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057140",
            "telephone_number": "918-747-1600",
            "fax_number": "918-749-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057140",
            "telephone_number": "918-747-1600",
            "fax_number": "918-749-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDECK",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "M.S., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "1250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med-X Corporation
• Srinivas Medavarapu, M.D.
• Misty Medcalf
• Medcross.Org
• Mede, LLC
• Medefy Health LLC
• Medexpress Urgent Care, PC - Oklahoma
• Medfund LLC
• Medic-Aire of Tahlequah, Inc.
• Medical & Cosmetic Center

• Professional Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.