Individual provider Active NPI

Jessica Pendergraft

  • Mental Health Counselor
  • Enid, OK
National Provider Identifier
1659771996
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6723 Issued in OK
Practice address
300 W Cherokee Ave Ste 102
Enid, OK 73701-5600
Phone
(580) 340-7235
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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 6723 OK Primary

Addresses

Primary practice location

300 W Cherokee Ave Ste 102
Enid, OK 73701-5600

Mailing address

615 Amy Dr
Waukomis, OK 73773-1033
Phone (580) 478-5035

Other practice location 1

615 Amy Dr
Waukomis, OK 73773-1033
Phone (580) 478-5035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Counseling Solutions PLLC CurrentSince Jan 2, 2024 Accepting new patients

Locations

300 W Cherokee Ave
Ste 102
Enid, OK 73701
Phone (580) 340-7235

Organizations & group practices 1

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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1659771996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 AMY DR",
            "city": "WAUKOMIS",
            "state": "OK",
            "postal_code": "737731033",
            "telephone_number": "580-478-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CHEROKEE AVE STE 102",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015600",
            "telephone_number": "580-340-7235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Amy Dr",
            "address_purpose": "LOCATION",
            "city": "Waukomis",
            "state": "OK",
            "postal_code": "737731033",
            "country_code": "US",
            "telephone_number": "580-478-5035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDERGRAFT",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "6723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.