Individual provider Active NPI

Tina Lajean Newberry

  • Counselor
  • Sapulpa, OK
National Provider Identifier
1629350384
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
23 E Ross Ave
Sapulpa, OK 74066-6423
Phone
(918) 216-4622
NPI assigned
Sep 19, 2011
Last updated
Sep 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

23 E Ross Ave
Sapulpa, OK 74066-6423

Mailing address

504 S Williams St
Stilwell, OK 74960-3642
Phone (918) 696-7190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240103000018 OK Practitioner - Mental Health Counselor 6507118056 Reassigns benefits to 1 organization
I20251124002157 TX Practitioner - Mental Health Counselor 6507118056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1505 E Main St
Stigler, OK 74462-2914
Phone (800) 640-9741

2013 E Meadow LN
Stigler, OK 74462-2708

PO Box
Suite 179
Stigler, OK 74462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Nov 2, 2025 Accepting new patients
Cherokee Nation CurrentSince Nov 2, 2025 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Stigler Health and Wellness Center Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

1630 S Kerr Blvd
Sallisaw, OK 74955
Phone (918) 790-2653

1505 E Main St
Stigler, OK 74462
Phone (800) 640-9741

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 5

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": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1629350384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S WILLIAMS ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749603642",
            "telephone_number": "918-696-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 E ROSS AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740666423",
            "telephone_number": "918-216-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "TINA",
        "middle_name": "LAJEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sapulpa, OK

Sources for this page

Verify at the official NPI Registry.