Active NPI
Kimberly Jackson
- Mental Health Counselor
- Tulsa, OK
National Provider Identifier
1528598463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1401 Charles Page Blvd
Tulsa, OK 74127-8820 - Phone
- (918) 521-7053
- Fax
- (918) 516-0233
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1401 Charles Page Blvd
Tulsa, OK 74127-8820
Mailing address
3720 Silver Oak CT
Tulsa, OK 74107-4050
Phone (918) 521-7053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497398400000",
"number": "1528598463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3720 SILVER OAK CT",
"city": "TULSA",
"state": "OK",
"postal_code": "741074050",
"telephone_number": "918-521-7053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 CHARLES PAGE BLVD",
"city": "TULSA",
"state": "OK",
"postal_code": "741278820",
"telephone_number": "918-521-7053",
"fax_number": "918-516-0233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2017-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.