Charles Tyler Kibbe, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

89025 Issued in TX

Practice address

9209 NW 85TH St
Yukon, OK 73099-9591

Phone

(972) 698-8478

NPI assigned

Jul 27, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK2 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tyler.kibbe.1@23300.direct.athenahealth.com

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.

• Brave Health Medical Group PA

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1225669161

  OK, TX

  Medicare reassignment
• Life Encouragers, Inc.

  • Mental Health Counselor
  • Sunnyvale, TX
  • NPI 1184848400
  NPD (past)
• Whitefields Health Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, TX
  • NPI 1366188039
  NPD (past)

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1336820711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9209 NW 85TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730999591",
            "telephone_number": "501-259-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9209 NW 85TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730999591",
            "telephone_number": "972-698-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBBE",
        "first_name": "CHARLES",
        "middle_name": "TYLER",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "89025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamyra Shana Kennedy-Jones
• Lindsay Kay Kennedy, ATC/LAT
• Angelia Dawn Kenney
• Courtney Lynn Ketch, M.D.
• Rahil Shariatzadeh Khalili, APRN
• Kids in Motion Mobile Pediatric Therapy LLC
• Joshua Blake Kiener, CRNA
• Wes Lee Kifer, DPH
• Noreen Kile
• Yong H Kim, PSY.D.

• Mental Health Counselor in Yukon, OK
• Providers in Yukon, 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 Dec 9, 2024; 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.