Individual provider Active NPI

Bria Danielle Tynes, M.S., LPC CANDIDATE

  • Counselor
  • Ardmore, OK
National Provider Identifier
1366928889
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
905 Holiday Dr
Ardmore, OK 73401-1216
Phone
(580) 226-5003
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

905 Holiday Dr
Ardmore, OK 73401-1216

Mailing address

276 Timber Rd
Ardmore, OK 73401-0620
Phone (580) 229-3870

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
I20260303000198 OK Practitioner - Mental Health Counselor 1658853403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse Behavioral Wellness CentersGroup PAC ID 6406748961, 59 clinicians

Practice addresses (Care Compare)

2530 S Commerce St
BLDG B
Ardmore, OK 73401-5519
Phone (580) 223-5636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Wellness Centers CurrentSince Feb 4, 2026 Accepting new patients
Lighthouse Behavioral Wellness Centers CurrentSince Feb 4, 2026 Accepting new patients
Southern Oklahoma Treatment Services, Inc. Past Accepting new patients

Locations

2530 S Commerce St
Bldg B
Ardmore, OK 73401
Phone (580) 319-7305

Organizations & group practices 3

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1366928889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 TIMBER RD",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734010620",
            "telephone_number": "580-229-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 HOLIDAY DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011216",
            "telephone_number": "580-226-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNES",
        "first_name": "BRIA",
        "middle_name": "DANIELLE",
        "credential": "M.S., LPC CANDIDATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.