Individual provider Active NPI

Marti Leeann Nichols, LBHP

  • Mental Health Counselor
  • Colcord, OK
National Provider Identifier
1538495692
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1274 Issued in OK
Practice address
56577 County Road 660
Colcord, OK 74338-2520
Phone
(918) 864-0353
NPI assigned
Oct 26, 2009
Last updated
Nov 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1274 OK Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X OK
Rehabilitation Psychologist 103TR0400X NU

Addresses

Primary practice location

56577 County Road 660
Colcord, OK 74338-2520

Mailing address

56577 County Road 660
Colcord, OK 74338-2520
Phone (918) 864-0353

Other identifiers 1

IdentifierTypeStateIssuer
200375130AMedicaidOK

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
I20251201000371 OK Practitioner - Mental Health Counselor 4981197811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Mental Health, LLCGroup PAC ID 0345670733, 27 clinicians

Practice addresses (Care Compare)

1402 N Florence Ave
Suite B
Claremore, OK 74017-3159
Phone (918) 608-0380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Mental Health, LLC Mental Health CurrentSince Nov 1, 2025 Accepting new patients
Alliance Mental Health, LLC Mental Health CurrentSince Nov 1, 2025 Accepting new patients
Rural Recovery Counseling Services, LLC Addiction (Substance Use Disorder) CurrentSince Apr 20, 2025 Accepting new patients
Pushmataha Counseling Services, Inc. Past Accepting new patients
Pushmataha Counseling Services, Inc. Past Accepting new patients

Locations

1402 N Florence Ave
Ste B
Claremore, OK 74017
Phone 9186080380716

Organizations & group practices 5

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": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1538495692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56577 COUNTY ROAD 660",
            "city": "COLCORD",
            "state": "OK",
            "postal_code": "743382520",
            "telephone_number": "918-864-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56577 COUNTY ROAD 660",
            "city": "COLCORD",
            "state": "OK",
            "postal_code": "743382520",
            "telephone_number": "918-864-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARTI",
        "middle_name": "LEEANN",
        "credential": "LBHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "1274",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200375130A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colcord, OK

Sources for this page

Verify at the official NPI Registry.