Individual provider Active NPI

Kristen Nicole Blansett

  • Addiction (Substance Use Disorder) Counselor
  • Tulsa, OK
National Provider Identifier
1346562337
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
5319 S Lewis Ave
Tulsa, OK 74105
Phone
(918) 832-7763
Fax
(918) 292-8250
NPI assigned
Feb 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1154 OK
Mental Health Counselor 101YM0800X OK
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

5319 S Lewis Ave
Tulsa, OK 74105

Mailing address

5319 S Lewis Ave
Tulsa, OK 74105
Phone (918) 832-7763

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
1154OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Palmer Continuum of Care, Inc. PastSince Sep 20, 2020 Accepting new patients
Palmer Continuum of Care Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 2

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": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1346562337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74105",
            "telephone_number": "918-832-7763",
            "fax_number": "918-292-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74105",
            "telephone_number": "918-832-7763",
            "fax_number": "918-292-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANSETT",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "1154",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.