Individual provider Active NPI

Marilyn Elizabeth Kincade, LPC, NCC

  • Counselor
  • Boley, OK
National Provider Identifier
1295804086
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC #924 Issued in OK
Practice address
RR 1, Box 35D
Boley, OK 74829
Phone
(918) 667-3367
Fax
(918) 667-3387
NPI assigned
Nov 7, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC #924 OK Primary
Counselor 101Y00000X NCC #9091 OK

Addresses

Primary practice location

RR 1, Box 35D
Boley, OK 74829

Mailing address

131 E 17TH St
Wewoka, OK 74884-3906
Phone (405) 257-6863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC #924OKMDCounselor
NCC #9091OKMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295804086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 E 17TH ST",
            "city": "WEWOKA",
            "state": "OK",
            "postal_code": "748843906",
            "telephone_number": "405-257-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1, BOX 35D",
            "city": "BOLEY",
            "state": "OK",
            "postal_code": "74829",
            "telephone_number": "918-667-3367",
            "fax_number": "918-667-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCADE",
        "first_name": "MARILYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "LPC #924",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "NCC #9091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boley, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.