Active NPI
Mary Marie Nichols, LPC-CANDIDATE
- Professional Counselor
- Edmond, OK
National Provider Identifier
1376492447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPCCANDIDATE13196
- Practice address
- 15128 Traditions Blvd Ste a
Edmond, OK 73013-1220 - Phone
- (405) 474-5359
- NPI assigned
- Jan 22, 2026
- Last updated
- Jan 22, 2026
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPCCANDIDATE13196 | OK | Primary |
Addresses
Primary practice location
15128 Traditions Blvd Ste a
Edmond, OK 73013-1220
Mailing address
PO Box 282
Luther, OK 73054-0282
Phone (405) 439-4067
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCCANDIDATE13196 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769040000000",
"number": "1376492447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 282",
"city": "LUTHER",
"state": "OK",
"postal_code": "730540282",
"telephone_number": "405-439-4067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15128 TRADITIONS BLVD STE A",
"city": "EDMOND",
"state": "OK",
"postal_code": "730131220",
"telephone_number": "405-474-5359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "MARY",
"middle_name": "MARIE",
"credential": "LPC-CANDIDATE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-01-22",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "LPCCANDIDATE13196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.