Active NPI
Mary Kathryn Tyson, MAPC, LPC
- Professional Counselor
- Tulsa, OK
National Provider Identifier
1538764790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10918
- Practice address
- 9820 E 41St St Ste 400
Tulsa, OK 74146-3616 - Phone
- (918) 641-4241
- NPI assigned
- Dec 3, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 10918 | OK | Primary |
Addresses
Primary practice location
9820 E 41St St Ste 400
Tulsa, OK 74146-3616
Mailing address
411 E Duncan St
Jenks, OK 74037-4525
Phone (919) 606-6893
Other practice location 1
6440 S Lewis Ave Ste 2200
Tulsa, OK 74136-1060
Phone (918) 712-0859
Other names 1
- Mary Kathryn Desjardins
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Tulsa | Health Information Exchange (HIE) |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715299200000",
"number": "1538764790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 E DUNCAN ST",
"city": "JENKS",
"state": "OK",
"postal_code": "740374525",
"telephone_number": "919-606-6893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9820 E 41ST ST STE 400",
"city": "TULSA",
"state": "OK",
"postal_code": "741463616",
"telephone_number": "918-641-4241"
}
],
"practiceLocations": [
{
"address_1": "6440 S Lewis Ave Ste 2200",
"address_purpose": "LOCATION",
"city": "Tulsa",
"state": "OK",
"postal_code": "741361060",
"country_code": "US",
"telephone_number": "918-712-0859",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TYSON",
"first_name": "MARY KATHRYN",
"credential": "MAPC, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-03",
"last_updated": "2024-05-10",
"certification_date": "2024-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "10918",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Tulsa",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "9820 E 41st St Ste 400",
"city": "Tulsa",
"state": "OK",
"country_code": "US",
"postal_code": "741463616",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARY KATHRYN",
"last_name": "DESJARDINS",
"credential": "MAPC, LPC-C",
"code": "2",
"type": "Professional Name"
}
]
}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 May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.