Individual provider Active NPI

Simonne Cassandra Jones

  • Mental Health Counselor
  • Tulsa, OK
National Provider Identifier
1376963579
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
080777677 Issued in OK
Practice address
9177 E Newton St
Tulsa, OK 74115-5939
Phone
(918) 899-6508
NPI assigned
Apr 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 080777677 OK Primary

Addresses

Primary practice location

9177 E Newton St
Tulsa, OK 74115-5939

Mailing address

907 S. Detroit Ave
Tulsa, OK 74120
Phone (918) 508-4563

Other names 1

  • Simonne Cassandra Miller Former name

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
I20240530002506 OK Practitioner - Mental Health Counselor 9133561590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3606 N Martin Luther King Jr Blvd
Sydlyfe Counseling Service LLC
Tulsa, OK 74106-6459
Phone (918) 949-4212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080777677OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Humblebee Counseling LLC Mental Health Current Accepting new patients
Sydlyfe Counseling Services, LLC CurrentSince May 11, 2025 Accepting new patients
Anew Dawn Counseling Services LLC Mental Health CurrentSince May 17, 2024 Accepting new patients

Locations

2227 S Garnett Rd
Ste 106
Tulsa, OK 74129
Phone (918) 409-9677

3606 N Martin Luther King Jr Blvd
Tulsa, OK 74106
Phone (918) 728-8512

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": "1398556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1376963579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 S. DETROIT AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74120",
            "telephone_number": "918-508-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9177 E NEWTON ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741155939",
            "telephone_number": "918-899-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SIMONNE",
        "middle_name": "CASSANDRA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "080777677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIMONNE",
            "last_name": "MILLER",
            "middle_name": "CASSANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.