Individual provider Active NPI

Courtney Brooke See Elizondo, M.ED., LPC

  • Mental Health Counselor
  • Oklahoma City, OK
National Provider Identifier
1255632626
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4911 Issued in OK
Practice address
2617 General Pershing Blvd
Oklahoma City, OK 73107-6437
Phone
(405) 858-1700
Fax
(405) 858-1776
NPI assigned
Nov 16, 2010
Last updated
Oct 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4911 OK Primary

Addresses

Primary practice location

2617 General Pershing Blvd
Oklahoma City, OK 73107-6437

Mailing address

PO Box 12978
Oklahoma City, OK 73157-2978
Phone (405) 858-1700

Other identifiers 1

IdentifierTypeStateIssuer
200390430AMedicaidOK

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
I20240826004248 OK Practitioner - Mental Health Counselor 6709325418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2617 General Pershing Blvd
Oklahoma City, OK 73107-6437
Phone (405) 858-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
4911OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Oklahoma County Mental Health Center Mental Health CurrentSince Jun 22, 2024 Accepting new patients

Locations

2617 General Pershing Blvd
Oklahoma City, OK 73107
Phone (405) 858-1700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1255632626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12978",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731572978",
            "telephone_number": "405-858-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 GENERAL PERSHING BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076437",
            "telephone_number": "405-858-1700",
            "fax_number": "405-858-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEE ELIZONDO",
        "first_name": "COURTNEY",
        "middle_name": "BROOKE",
        "credential": "M.ED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "4911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200390430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.