Shana Niccum, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10246 Issued in OK

Practice address

2325 S Harvard Ave
Tulsa, OK 74114-3300

Phone

(918) 712-4301

NPI assigned

Apr 5, 2018

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family & Children's Services, Inc

  dba F&CS

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1023122439
  Medicare reassignment NPD

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1295231330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICCUM",
        "first_name": "SHANA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "10246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200779150A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tommy Tien Nguyen, M.D.
• Truyen Duc Nguyen, DDS
• Tuong-Lan Pham Nguyen, PHARMD
• Uyen T Nguyen
• Vivian Nguyen
• Jayse Michelle Nicholas
• Kathleen Ellison Nicholas, M.S. CCC-SLP
• Rebecca Lynn Nicholas, PSYCHOLOGIST, ED.D.
• Amanda J Nichols, DO
• Christopher Daniel Nichols, LMSW

• Mental Health Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.