Jeniece Ann Bridgforth, LPC- CANDIDATE
Individual provider Active NPI Mental Health Counselor · McLoud, OK
NPI 1669639720 · NPPES record last updated Mar 23, 2026
Key facts
- NPI
- 1669639720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 13313 (OK)
- Practice address
- 12617 S McLoud Rd
McLoud, OK 74851-8509 - Phone
- (405) 481-4755
- NPI assigned
- May 16, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13313 | OK | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 13313 | OK | Yes |
Addresses
Primary practice location
12617 S McLoud Rd
McLoud, OK 74851-8509
Mailing address
12617 S McLoud Rd
McLoud, OK 74851-8509
Phone (405) 481-4755
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100742400F | Medicaid | OK | |
| 100742400 B | Medicaid | OK |
Other providers in McLoud, OK
- Mark Cody Banta
- Melissa Dawn Barnes
- Sarah Elizabeth Becker
- Amy Bowen
- Rhonda Jo Bowen
- Christian Carter Brown
- Jessica Nicole Cantrell
- Vivian Carpenter
- Savannah Carrothers
- Payton Chandler
All providers in McLoud, OK · Mental Health Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.