Active NPI
Bria Danielle Tynes, M.S., LPC CANDIDATE
- Counselor
- Ardmore, OK
National Provider Identifier
1366928889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Behavioral Wellness Centers | Current | Accepting new patients | |
| Lighthouse Behavioral Wellness Centers | Current | 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.
-
- Community/Behavioral Health Agency
- Ardmore, OK
- NPI 1518997097
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ardmore, OK
- NPI 1881884807
-
- Methadone Clinic
- Ardmore, OK
- NPI 1083786719
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.