Jeannerosa Depaz Lay, MS, CM-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2010 Boren Blvd
Seminole, OK 74868-2050

Phone

(405) 382-4507

Fax

(405) 382-5269

NPI assigned

Jun 4, 2007

Last updated

Mar 6, 2024By the provider in NPPES

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

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, 2002

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

Credentials

Certified Medical Assistant, Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1487856126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 BOREN BLVD",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748682050",
            "telephone_number": "405-382-4507",
            "fax_number": "405-382-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BOREN BLVD",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748682050",
            "telephone_number": "405-382-4507",
            "fax_number": "405-382-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAY",
        "first_name": "JEANNEROSA",
        "middle_name": "DEPAZ",
        "name_prefix": "Mrs.",
        "credential": "MS, CM-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Leon Kemp, D.O.
• Stephanie Marie Killian, RN, BSN
• Kaitlyn Marie Kipps
• Rachel Lea Kolander
• Amanda Lauren Kuehner, APRN-CNP
• Lawena Irene Lee, LPC
• Lighthouse Behavioral Wellness Centers
• Lighthouse Behavioral Wellness Centers
• Lincare Inc.
• Christina Little, PA-C

• Mental Health Counselor in Seminole, OK
• Providers in Seminole, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.