Individual provider Active NPI

Jaynee Marie Nelson, LPC, LADC/MH

  • Professional Counselor
  • Lawton, OK
National Provider Identifier
1356619431
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7051 Issued in OK
Practice address
2305 SW H Ave
1
Lawton, OK 73505-8103
Phone
(580) 678-6660
Fax
(405) 735-6116
NPI assigned
Dec 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1249 OK
Professional Counselor 101YP2500X 7051 OK Primary

Addresses

Primary practice location

2305 SW H Ave
1
Lawton, OK 73505-8103

Mailing address

1311 SW Washington Ave
Lawton, OK 73501-7231
Phone (580) 678-6660

Other practice location 1

1311 SW Washington Ave
Lawton, OK 73501-7231
Phone (580) 678-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7051OKMDProfessional Counselor
1249OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inertia Services LLC Addiction (Substance Use Disorder) Past Accepting new patients

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": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1356619431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 SW WASHINGTON AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735017231",
            "telephone_number": "580-678-6660",
            "fax_number": "405-735-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 SW H AVE",
            "address_2": "1",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058103",
            "telephone_number": "580-678-6660",
            "fax_number": "405-735-6116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1311 SW Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Lawton",
            "state": "OK",
            "postal_code": "735017231",
            "country_code": "US",
            "telephone_number": "580-678-6660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JAYNEE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPC, LADC/MH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "1249",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "7051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.