Individual provider Active NPI

Mercede McClure, LPC CANDIDATE

  • Counselor
  • Tulsa, OK
National Provider Identifier
1518587385
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPCCANDIDATE10738 Issued in OK
Practice address
2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone
(918) 582-7228
Fax
(918) 382-1881
NPI assigned
Apr 22, 2020
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPCCANDIDATE10738 OK Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

2325 S Harvard Ave
Tulsa, OK 74114-3300

Mailing address

14700 E 88TH PL N Apt 323
Owasso, OK 74055-4936
Phone (918) 857-9846

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
I20240907000548 OK Practitioner - Mental Health Counselor 9436699246 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCCANDIDATE10738OKMDCounselor
10738OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children's Services, Inc CurrentSince Aug 9, 2024 Accepting new patients

Locations

2325 S Harvard Ave
Tulsa, OK 74114
Phone (918) 921-3200

650 S Peoria Ave
Tulsa, OK 74120
Phone (918) 749-6095

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1518587385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 E 88TH PL N APT 323",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554936",
            "telephone_number": "918-857-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-582-7228",
            "fax_number": "918-382-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "MERCEDE",
        "credential": "LPC CANDIDATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "LPCCANDIDATE10738",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.