Jessica Ann Kozarevich, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3567 Issued in OK

Practice address

1500 N 6TH St
Ponca City, OK 74601-2827

Phone

(580) 762-7561

Fax

(580) 762-2576

NPI assigned

Jul 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healing Heart and Mind Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ponca City, OK
  • NPI 1821403643
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1609188291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 S UNION ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746017612",
            "telephone_number": "580-765-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N 6TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012827",
            "telephone_number": "580-762-7561",
            "fax_number": "580-762-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAREVICH",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "3567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Rae Kizziar, RSS
• Melissa Kizziar
• KLR Innovations LLC
• Nathan David Koch, PTA
• Jennifer Kohl, PTA
• Stacy Lee Kraft, LCSW
• Sigrid Renee Krause, M.S.
• Ron M Kreger, M.D.
• Bridget Nicole Kreisel-Miller
• Lauren R Krittenbrink

• Mental Health Counselor in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.