Individual provider Active NPI

Cassandra Lee Cummins, MBS LPC

  • Counselor
  • Poteau, OK
National Provider Identifier
1275769937
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3809 Issued in OK
Practice address
804 S Broadway St
Poteau, OK 74953-3834
Phone
(918) 647-9629
Fax
(918) 649-0136
NPI assigned
Jun 8, 2009
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3809 OK Primary

Addresses

Primary practice location

804 S Broadway St
Poteau, OK 74953-3834

Mailing address

804 S Broadway St
Poteau, OK 74953-3834
Phone (918) 647-9629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240109003348 OK Practitioner - Mental Health Counselor 6406207992 Reassigns benefits to 1 organization
I20240506003532 TX Practitioner - Mental Health Counselor 6406207992 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3809OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Apr 21, 2024 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Apr 21, 2024 Accepting new patients
Center for Psychological Development, Inc. Counselor CurrentSince Jan 1, 2024 Accepting new patients
Southern Oklahoma Treatment Services, Inc. Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

106 S 3rd St
McAlester, OK 74501
Phone (918) 421-8880

1127 S George Nigh Expy
McAlester, OK 74501
Phone (918) 423-8440

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

804 S Broadway St
Poteau, OK 74953
Phone (918) 647-9269

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

1105 Memorial Dr
Ste 202
Denison, TX 75020
Phone (903) 337-0343

Organizations & group practices 5

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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1275769937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 S BROADWAY ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749533834",
            "telephone_number": "918-647-9629",
            "fax_number": "918-649-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S BROADWAY ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749533834",
            "telephone_number": "918-647-9629",
            "fax_number": "918-649-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINS",
        "first_name": "CASSANDRA",
        "middle_name": "LEE",
        "credential": "MBS LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "3809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

Verify at the official NPI Registry.