Individual provider Active NPI

Kimberly Ann Lovelace, LPC CANDIDATE

  • Mental Health Counselor
  • Wagoner, OK
National Provider Identifier
1699086033
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
109 S Harrill Ave
Wagoner, OK 74467-5317
Phone
(918) 485-3554
Fax
(918) 485-8371
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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 Primary

Addresses

Primary practice location

109 S Harrill Ave
Wagoner, OK 74467-5317

Mailing address

109 S Harrill Ave
Wagoner, OK 74467-5317
Phone (918) 485-3554

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
I20241009002301 OK Practitioner - Mental Health Counselor 2860923224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Improving Lives Counseling Services, Inc. CurrentSince Jul 28, 2024 Accepting new patients

Locations

6216 S Lewis Ave
Ste 180
Tulsa, OK 74136
Phone (918) 289-6531

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1699086033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S HARRILL AVE",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744675317",
            "telephone_number": "918-485-3554",
            "fax_number": "918-485-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S HARRILL AVE",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744675317",
            "telephone_number": "918-485-3554",
            "fax_number": "918-485-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC CANDIDATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

Verify at the official NPI Registry.