Individual provider Active NPI

Penny Dawn Sarabia, M.ED.

  • Counselor
  • Ardmore, OK
National Provider Identifier
1659699130
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
4682 Issued in OK
Practice address
2015 W Broadway St Ste 51a
Ardmore, OK 73401-2501
Phone
(580) 226-9388
Fax
(580) 226-9395
NPI assigned
May 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X
Counselor 101Y00000X 4682 OK Primary

Addresses

Primary practice location

2015 W Broadway St Ste 51a
Ardmore, OK 73401-2501

Mailing address

2015 W Broadway St Ste 51a
Ardmore, OK 73401-2501
Phone (580) 226-9388

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
I20250326000070 OK Practitioner - Mental Health Counselor 9436672961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse Behavioral Wellness CentersGroup PAC ID 6406748961, 59 clinicians

Practice addresses (Care Compare)

109 S Willow St
Pauls Valley, OK 73075-3833
Phone (405) 238-7311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
4682OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Wellness Centers CurrentSince Jan 19, 2025 Accepting new patients
Lighthouse Behavioral Wellness Centers Current Accepting new patients

Locations

2530 S Commerce St
Bldg B
Ardmore, OK 73401
Phone (580) 319-7305

109 S Willow St
Pauls Valley, OK 73075
Phone (405) 238-7311

Organizations & group practices 2

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": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1659699130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 W BROADWAY ST STE 51A",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012501",
            "telephone_number": "580-226-9388",
            "fax_number": "580-226-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W BROADWAY ST STE 51A",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012501",
            "telephone_number": "580-226-9388",
            "fax_number": "580-226-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARABIA",
        "first_name": "PENNY",
        "middle_name": "DAWN",
        "credential": "M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "4682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.