Kendra Mathis, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2425 W University Blvd Ste 102
Durant, OK 74701-2970

Phone

(580) 924-7330

Fax

(580) 924-7334

NPI assigned

Dec 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kendra Day Former name

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

Specialty

Mental Health Counselor

Education

Other, 2019

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)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lighthouse Behavioral Wellness Centers

  • Community/Behavioral Health Agency
  • Ardmore, OK
  • NPI 1518997097
  Medicare reassignment Care Compare group NPD
• Lighthouse Behavioral Wellness Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ardmore, OK
  • NPI 1881884807
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1407211402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S HIGH ST",
            "city": "ANTLERS",
            "state": "OK",
            "postal_code": "745233818",
            "telephone_number": "580-298-2830",
            "fax_number": "580-298-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W UNIVERSITY BLVD STE 102",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012970",
            "telephone_number": "580-924-7330",
            "fax_number": "580-924-7334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 N 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Durant",
            "state": "OK",
            "postal_code": "747014718",
            "country_code": "US",
            "telephone_number": "580-745-9276 x58029",
            "fax_number": "580-920-9056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "KENDRA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "DAY",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marshall County Hma LLC
• Marshall County Hma, LLC
• Connor Elise Marshall, DDS
• Lora Suzanne Martin
• Jonathan Warren Mason
• Kathleen Ray Matlock-Parson, B.H.R.S.
• Ethan Matson
• Weslina Jo Maxey, COTA
• Mary Octavia Maxwell
• Shirley Ann Mayfield

• Counselor in Durant, OK
• Providers in Durant, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.

Verify at the official NPI Registry.