Individual provider Active NPI

Shawn Douglas Roberts, LPC

  • Counselor
  • Duncan, OK
National Provider Identifier
1629632187
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
10789 Issued in OK
Practice address
2635 W Elk Ave
Duncan, OK 73533-1572
Phone
(580) 252-6080
NPI assigned
Apr 30, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 10789 OK Primary
Counseling Psychologist 103TC1900X

Addresses

Primary practice location

2635 W Elk Ave
Duncan, OK 73533-1572

Mailing address

910 SW E Ave
Lawton, OK 73501-4593
Phone (580) 699-5550

Other practice location 1

951 W Maple Ave
Duncan, OK 73533-4903
Phone (580) 360-8775

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
I20241007003929 OK Practitioner - Mental Health Counselor 3678004272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duncan Regional Hospital, IncGroup PAC ID 5193613057, 69 clinicians

Practice addresses (Care Compare)

2635 W Elk Ave
Duncan, OK 73533-1572
Phone (580) 252-6080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10789OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Duncan Regional Hospital, Inc Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients
Duncan Regional Hospital, Inc Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients
Duncan Regional Hospital, Inc. Multi-Specialty Current Accepting new patients

Locations

2515 W Elk Ave
Duncan, OK 73533
Phone (580) 252-6080

2434 Harville Rd
Ste 601
Duncan, OK 73533
Phone (580) 252-1373

Interoperability endpoints

  • Direct secure messaging: shawn.roberts@direct.drhhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1629632187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 SW E AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735014593",
            "telephone_number": "580-699-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 W ELK AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331572",
            "telephone_number": "580-252-6080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 W Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Duncan",
            "state": "OK",
            "postal_code": "735334903",
            "country_code": "US",
            "telephone_number": "580-360-8775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SHAWN",
        "middle_name": "DOUGLAS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-30",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "OK",
            "license": "10789",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

Verify at the official NPI Registry.