Individual provider Active NPI

Kellyn Hampton

  • Mental Health Counselor
  • Tahlequah, OK
National Provider Identifier
1497059968
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10795 Issued in CO
Practice address
711 S Muskogee Ave
Tahlequah, OK 74464-4717
Phone
(918) 207-0078
NPI assigned
Dec 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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 10795 CO Primary

Addresses

Primary practice location

711 S Muskogee Ave
Tahlequah, OK 74464-4717

Mailing address

22005 E 660 Rd
Tahlequah, OK 74464-8230
Phone (720) 402-5977

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
I20240514001048 OK Practitioner - Mental Health Counselor 0042651606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creoks Mental Health ServicesGroup PAC ID 0749591469, 39 clinicians

Practice addresses (Care Compare)

711 S Muskogee Ave
Tahlequah, OK 74464-4717
Phone (918) 207-0078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10795COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creoks Mental Health Services CurrentSince Apr 6, 2024 Accepting new patients
Creoks Mental Health Services Current Accepting new patients
Creoks Mental Health Services CurrentSince Apr 6, 2024 Accepting new patients

Locations

711 S Muskogee Ave
Tahlequah, OK 74464
Phone (918) 207-0078

4103 S Yale Ave
Ste B
Tulsa, OK 74135
Phone (918) 382-7302

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": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1497059968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22005 E 660 RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744648230",
            "telephone_number": "720-402-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644717",
            "telephone_number": "918-207-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPTON",
        "first_name": "KELLYN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "10795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.