Individual provider Active NPI

Shawnda Pauline Kirchmann, L.P.C.

  • Counselor
  • Grove, OK
National Provider Identifier
1700242591
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
7705 Issued in OK
Practice address
1115 Harbor Rd
Grove, OK 74344-3505
Phone
(918) 786-4434
Fax
(918) 786-4435
NPI assigned
Jan 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 7705 OK Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1115 Harbor Rd
Grove, OK 74344-3505

Mailing address

1115 Harbor Rd
Grove, OK 74344-3505
Phone (918) 786-4434

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
I20231215001757 OK Practitioner - Mental Health Counselor 9335598390 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 Jan 1, 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": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1700242591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 HARBOR RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743443505",
            "telephone_number": "918-786-4434",
            "fax_number": "918-786-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 HARBOR RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743443505",
            "telephone_number": "918-786-4434",
            "fax_number": "918-786-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHMANN",
        "first_name": "SHAWNDA",
        "middle_name": "PAULINE",
        "name_prefix": "Mrs.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-08",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "7705",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove, OK

Sources for this page

Verify at the official NPI Registry.