Individual provider Active NPI

Michele Deann Brake, LPC

  • Mental Health Counselor
  • McAlester, OK
National Provider Identifier
1639320971
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC05503 Issued in OK
Practice address
1101 E Monroe Ave
McAlester, OK 74501-4815
Phone
(918) 470-0285
Fax
(918) 426-5837
NPI assigned
Oct 6, 2008
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC05503 OK Primary
Professional Counselor 101YP2500X LPC05503 OK

Addresses

Primary practice location

1101 E Monroe Ave
McAlester, OK 74501-4815

Mailing address

1127 S George Nigh Expy
McAlester, OK 74501-7143
Phone (918) 423-8440

Other identifiers 2

IdentifierTypeStateIssuer
163932071MedicaidOK
101YM0800XMedicaidOK

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
I20240209002499 OK Practitioner - Mental Health Counselor 1658714373 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC05503OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
State of Oklahoma CurrentSince Jan 1, 2024 Accepting new patients
State of Oklahoma Current Accepting new patients
State of Oklahoma CurrentSince Jan 1, 2024 Accepting new patients

Locations

1101 E Monroe Ave
McAlester, OK 74501
Phone (918) 426-7878

2323 S Harvard Ave
Tulsa, OK 74114
Phone (918) 293-2140

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": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1639320971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 S GEORGE NIGH EXPY",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745017143",
            "telephone_number": "918-423-8440",
            "fax_number": "918-421-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E MONROE AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014815",
            "telephone_number": "918-470-0285",
            "fax_number": "918-426-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKE",
        "first_name": "MICHELE",
        "middle_name": "DEANN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "LPC05503",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "LPC05503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163932071",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.