Active NPI
Marilyn Elizabeth Kincade, LPC, NCC
- Counselor
- Boley, OK
National Provider Identifier
1295804086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC #924
- 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, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC #924 | OK | MD | Counselor |
| NCC #9091 | OK | MD | Counselor |
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.