Individual provider Active NPI

Kenneth Warren Norris, LPC

  • Counselor
  • Atoka, OK
National Provider Identifier
1366723629
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC07565 Issued in OK
Practice address
1697 S Greathouse Dr
Atoka, OK 74525-3407
Phone
(580) 889-5555
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X LPC07565 OK Primary

Addresses

Primary practice location

1697 S Greathouse Dr
Atoka, OK 74525-3407

Mailing address

228 N Russell Ave
Atoka, OK 74525-1644
Phone (580) 889-9848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240709003794 OK Practitioner - Mental Health Counselor 6103361654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC07565OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Counseling LLC Single Specialty CurrentSince May 15, 2024 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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1366723629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 N RUSSELL AVE",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745251644",
            "telephone_number": "580-889-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1697 S GREATHOUSE DR",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253407",
            "telephone_number": "580-889-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KENNETH",
        "middle_name": "WARREN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "OK",
            "license": "LPC07565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atoka, OK

Sources for this page

Verify at the official NPI Registry.