Zachary Tedder, LPC
Individual provider Active NPI Professional Counselor · Earlsboro, OK
NPI 1356863070 · NPPES record last updated Nov 25, 2025
Key facts
- NPI
- 1356863070
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 7271 (OK)
- Practice address
- 18800 Valley View Rd
Earlsboro, OK 74840-3610 - Phone
- (405) 279-9416
- NPI assigned
- Jul 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
18800 Valley View Rd
Earlsboro, OK 74840-3610
500 Westover Dr
Sanford, NC 27330-8941
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260127004256 | OK | Practitioner - Mental Health Counselor | 5597243030 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7271 | OK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Professional | Current |
Accepting new patients |
Locations
101 Park Ave
Oklahoma City, OK 73102
Phone (405) 442-4940
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7271 | OK | Yes |
Addresses
Primary practice location
18800 Valley View Rd
Earlsboro, OK 74840-3610
Mailing address
18800 Valley View Rd
Earlsboro, OK 74840-3610
Other practice location 1
624 W Independence St Ste 105
Shawnee, OK 74804-4329
Phone (405) 279-9416
Other providers in Earlsboro, OK
- Mallory Dinsmore
- Cheri Dawn Hardeman
- Raven Lynn McClain
- Michael E Salrin Health Service, Inc
- Tedder Therapy Practice, PLLC
- Brianna Thorpe
- Daniel L. Wolfe
All providers in Earlsboro, OK · Professional Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.