Active NPI
Kiminece Redae, LPC
- Mental Health Counselor
- Del City, OK
National Provider Identifier
1346594850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 5505 Main Street
Del City, OK 73115-1315 - Phone
- (405) 609-6595
- NPI assigned
- Nov 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OK | Primary |
Addresses
Primary practice location
5505 Main Street
Del City, OK 73115-1315
Mailing address
5505 Main St
Del City, OK 73115-5509
Phone (405) 609-6595
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456704000000",
"number": "1346594850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5505 MAIN ST",
"city": "DEL CITY",
"state": "OK",
"postal_code": "731155509",
"telephone_number": "405-609-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5505 MAIN STREET",
"city": "DEL CITY",
"state": "OK",
"postal_code": "731151315",
"telephone_number": "405-609-6595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDAE",
"first_name": "KIMINECE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-06",
"last_updated": "2016-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Del City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.