Individual provider Active NPI

Deaira Puentes Soto, MS, NCC, LPC

  • Mental Health Counselor
  • Miami, OK
National Provider Identifier
1659797991
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6101 Issued in OK
Practice address
111 S Treaty Rd
Miami, OK 74354
Phone
(918) 540-1511
Fax
(918) 542-7374
NPI assigned
Mar 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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 6101 OK Primary

Addresses

Primary practice location

111 S Treaty Rd
Miami, OK 74354

Mailing address

114 W Delaware Ave
Nowata, OK 74048-2601
Phone (918) 273-1841

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
I20250312000674 OK Practitioner - Mental Health Counselor 8325569916 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center Inc. CurrentSince Mar 10, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Mar 10, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

3100 Medical Pkwy
Claremore, OK 74017
Phone (918) 341-2356

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

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": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1659797991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W DELAWARE AVE",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740482601",
            "telephone_number": "918-273-1841",
            "fax_number": "918-273-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S TREATY RD",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "74354",
            "telephone_number": "918-540-1511",
            "fax_number": "918-542-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUENTES SOTO",
        "first_name": "DEAIRA",
        "name_prefix": "Mrs.",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "6101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.