Individual provider Active NPI

Kathryn Nichols, LPC

  • Mental Health Counselor
  • Lawton, OK
National Provider Identifier
1578914768
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7159 Issued in OK
Practice address
1815 W Gore Blvd
Lawton, OK 73501-3614
Phone
(580) 514-8826
NPI assigned
Jun 29, 2016
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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 7159 OK Primary

Addresses

Primary practice location

1815 W Gore Blvd
Lawton, OK 73501-3614

Mailing address

3826 NW Euclid Ave
Lawton, OK 73505-4946
Phone (580) 514-8826

Other practice location 1

3826 NW Euclid Ave
Lawton, OK 73505-4946
Phone (580) 514-8826

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
I20241107001567 OK Practitioner - Mental Health Counselor 4183158579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7159OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Improving Lives Counseling Services, Inc. CurrentSince Oct 23, 2024 Accepting new patients

Locations

6216 S Lewis Ave
Ste 180
Tulsa, OK 74136
Phone (918) 289-6531

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1578914768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3826 NW EUCLID AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735054946",
            "telephone_number": "580-514-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735013614",
            "telephone_number": "580-514-8826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3826 NW Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Lawton",
            "state": "OK",
            "postal_code": "735054946",
            "country_code": "US",
            "telephone_number": "580-514-8826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KATHRYN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "7159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.