Individual provider Active NPI

Todd Palmer, LPC

  • Professional Counselor
  • Edmond, OK
National Provider Identifier
1306094818
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3463 Issued in OK
Practice address
15933 Loutain CT
Edmond, OK 73013-1657
Phone
(405) 706-1226
NPI assigned
Sep 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3463 OK Primary

Addresses

Primary practice location

15933 Loutain CT
Edmond, OK 73013-1657

Mailing address

15933 Loutain CT
Edmond, OK 73013-1657
Phone (405) 706-1226

Other identifiers 1

IdentifierTypeStateIssuer
200299330AMedicaidOK

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241213000706 OK Practitioner - Mental Health Counselor 8325447048 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3463OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inward Bound Health Solutions LLC Professional CurrentSince Feb 14, 2012 Accepting new patients

Locations

409 S Fretz Ave
Ste B
Edmond, OK 73003

1111 N Lee Ave
Ste 214
Oklahoma City, OK 73103
Phone (405) 516-0343

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1306094818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 LOUTAIN CT",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131657",
            "telephone_number": "405-706-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15933 LOUTAIN CT",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131657",
            "telephone_number": "405-706-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "TODD",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200299330A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.