Individual provider Active NPI

Jamie Roller, MCP, LPC

  • Counselor
  • Ponca City, OK
National Provider Identifier
1427397041
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
5901 Issued in OK
Practice address
2023 Turner St
Ponca City, OK 74604-2733
Phone
(580) 761-4227
NPI assigned
Feb 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Counselor 101Y00000X 5901 OK Primary

Addresses

Primary practice location

2023 Turner St
Ponca City, OK 74604-2733

Mailing address

2023 Turner
Ponca City, OK 74604
Phone (580) 716-3851

Other practice location 1

112 N High St
Antlers, OK 74523-2250
Phone (580) 298-3001

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
I20251002000757 OK Order and Referring Only - Mental Health Counselor 7810352077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901OKMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1427397041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 TURNER",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "74604",
            "telephone_number": "580-716-3851",
            "fax_number": "580-298-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 TURNER ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746042733",
            "telephone_number": "580-761-4227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 N High St",
            "address_purpose": "LOCATION",
            "city": "Antlers",
            "state": "OK",
            "postal_code": "745232250",
            "country_code": "US",
            "telephone_number": "580-298-3001",
            "fax_number": "580-298-5357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "JAMIE",
        "credential": "MCP, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "5901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

Verify at the official NPI Registry.