Individual provider Active NPI

Blong Lor, MS, LPC

  • Mental Health Counselor
  • Tulsa, OK
National Provider Identifier
1669974481
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC07377 Issued in OK
Practice address
6400 S Lewis Ave Ste 100
Tulsa, OK 74136-1019
Phone
(405) 378-2727
NPI assigned
Mar 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC07377 OK
Mental Health Counselor 101YM0800X LPC07377 OK Primary

Addresses

Primary practice location

6400 S Lewis Ave Ste 100
Tulsa, OK 74136-1019

Mailing address

6400 S Lewis Ave Ste 100
Tulsa, OK 74136-1019
Phone (405) 378-2727

Other identifiers 1

IdentifierTypeStateIssuer
200323940MedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: No
  • 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
I20250227003809 OK Practitioner - Mental Health Counselor 1557881984 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPC07377OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Women'S Health, LLC CurrentSince Dec 28, 2024 Accepting new patients

Locations

1105 SW 30th Ct
Moore, OK 73160
Phone (405) 378-4439

6400 S Lewis Ave
Ste 100
Tulsa, OK 74136
Phone (918) 270-4100

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": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1669974481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 S LEWIS AVE STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361019",
            "telephone_number": "405-378-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 S LEWIS AVE STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361019",
            "telephone_number": "405-378-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOR",
        "first_name": "BLONG",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-07",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "LPC07377",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "LPC07377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200323940",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.