Individual provider Active NPI

Landa Clinton, M.S., M.ED., LPC CAN

  • Mental Health Counselor
  • McAlester, OK
National Provider Identifier
1609142397
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
111 S Main St
McAlester, OK 74501-5303
Phone
(918) 423-5204
NPI assigned
Mar 27, 2012
Last updated
Sep 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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 NU Primary

Addresses

Primary practice location

111 S Main St
McAlester, OK 74501-5303

Mailing address

111 S Main St
McAlester, OK 74501-5303
Phone (918) 423-5204

Other identifiers 1

IdentifierTypeStateIssuer
200305190BMedicaidOK

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
I20250416003929 OK Practitioner - Mental Health Counselor 9032634514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Grand Lake Mental Health Center Inc. CurrentSince Apr 1, 2025 Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

Organizations & group practices 3

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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1609142397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S MAIN ST",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015303",
            "telephone_number": "918-423-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S MAIN ST",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015303",
            "telephone_number": "918-423-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "LANDA",
        "credential": "M.S., M.ED., LPC CAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200305190B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.