Kendall Bellefeuille, LPC CANDIDATE
Individual provider Active NPI Counselor · Ada, OK
NPI 1265202097 · NPPES record last updated Jan 3, 2024
Key facts
- NPI
- 1265202097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- LPCCANDIDATE11919 (OK)
- Practice address
- 1921 Stonecipher Dr
Ada, OK 74820-3439 - Phone
- (580) 436-3980
- NPI assigned
- Jan 3, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Chickasaw Nation Division of Health Chickasaw Nation Medical Center
Practice addresses (Care Compare)
1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980
Hospital & facility affiliations
- Chickasaw Nation Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260603000645 | TX | Practitioner - Mental Health Counselor | 4587135330 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCCANDIDATE11919 | OK | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chickasaw Nation Division of Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPCCANDIDATE11919 | OK | Yes |
Addresses
Primary practice location
1921 Stonecipher Dr
Ada, OK 74820-3439
Mailing address
1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980
Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.