Organization Active NPI

Wohl's Counseling Clinic,LLC

  • Mental Health Counselor
  • Ponca City, OK
National Provider Identifier
1427369057
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3745 Issued in OK
Legal business name
WOHL'S COUNSELING CLINIC,LLC
Practice address
400 E Central Ave
Ste.303E
Ponca City, OK 74601-5429
Phone
(580) 762-6511
Fax
(580) 762-6511
NPI assigned
Jun 29, 2010
Last updated
Jun 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Mrs. Samantha Jo Wohl, LPCNPI 1205931367
Title
Owner
Phone
(580) 762-6511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3745 OK Primary

Addresses

Primary practice location

400 E Central Ave
Ste.303E
Ponca City, OK 74601-5429

Mailing address

400 E Central Ave
Ste.303E
Ponca City, OK 74601-5429
Phone (580) 762-6511

Other identifiers 1

IdentifierTypeStateIssuer
200094600AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240913002787 OK Part B Supplier - Clinic/Group Practice 1850831009 Receives reassigned benefits from 1 practitioner
Practice locations: Ponca City, OK

National Provider Directory

National Provider Directory

Locations

1912 Lake Rd
Ponca City, OK 74604
Phone (580) 761-2373

400 E Central Ave
Ste 303E
Ponca City, OK 74601
Phone (580) 762-6511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1427369057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E CENTRAL AVE",
            "address_2": "STE.303E",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746015429",
            "telephone_number": "580-762-6511",
            "fax_number": "580-762-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E CENTRAL AVE",
            "address_2": "STE.303E",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746015429",
            "telephone_number": "580-762-6511",
            "fax_number": "580-762-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOHL'S COUNSELING CLINIC,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "WOHL",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-762-6511",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "3745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200094600A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.