Individual provider Active NPI

Kala Perez, M.S. M.ED.

  • Counselor
  • Coweta, OK
National Provider Identifier
1699118158
Registry record updated Oct 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
304 N Broadway
Coweta, OK 74429-2604
Phone
(918) 630-3552
NPI assigned
Apr 15, 2013
Last updated
Oct 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

304 N Broadway
Coweta, OK 74429-2604

Mailing address

6777 E 11TH St
Tulsa, OK 74112-4619
Phone (918) 273-2843

Other identifiers 1

IdentifierTypeStateIssuer
100746170GMedicaidOK

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
I20240103001628 OK Practitioner - Mental Health Counselor 8224488259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6777 E 11TH St
Tulsa, OK 74112-4619
Phone (918) 273-2843

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Just Breathe Counseling and Assessments CurrentSince Dec 1, 2023 Accepting new patients

Locations

10802 E 81st St
Tulsa, OK 74133
Phone (918) 203-0210

6777 E 11th St
Tulsa, OK 74112
Phone (918) 273-2843

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698451200000",
    "number": "1699118158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6777 E 11TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741124619",
            "telephone_number": "918-273-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N BROADWAY",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744292604",
            "telephone_number": "918-630-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "KALA",
        "credential": "M.S. M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2023-10-28",
        "certification_date": "2023-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100746170G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coweta, OK

Sources for this page

Verify at the official NPI Registry.