Individual provider Active NPI

Rue La Shelle Tennyson

  • Mental Health Counselor
  • Oklahoma City, OK
National Provider Identifier
1609193168
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC05122 Issued in OK
Practice address
3005 NW 63Rd St
Oklahoma City, OK 73116-3603
Phone
(405) 521-1755
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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 LPC05122 OK Primary

Addresses

Primary practice location

3005 NW 63Rd St
Oklahoma City, OK 73116-3603

Mailing address

15017 Kyle Dr Unit a
Moore, OK 73170-6513
Phone (405) 816-2276

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
I20250606001899 OK Practitioner - Mental Health Counselor 0941710115 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC05122OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Quest Mhsa CurrentSince May 16, 2025 Accepting new patients
Pathway to Hope LLC Mental Health Current Accepting new patients
Covenant Youth and Family Services Past Accepting new patients
Covenant Youth and Family Services Past Accepting new patients

Locations

307 SW B St
Antlers, OK 74523
Phone (580) 326-8605

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1609193168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15017 KYLE DR UNIT A",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731706513",
            "telephone_number": "405-816-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163603",
            "telephone_number": "405-521-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNYSON",
        "first_name": "RUE",
        "middle_name": "LA SHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "LPC05122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.