Individual provider Active NPI

Terri Goughler

  • Counselor
  • Tulsa, OK
National Provider Identifier
1750768800
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3015 E Skelly Dr
Suite 103
Tulsa, OK 74105-6317
Phone
(918) 712-0859
Fax
(918) 388-6456
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

3015 E Skelly Dr
Suite 103
Tulsa, OK 74105-6317

Mailing address

3015 E Skelly Dr
Suite 103
Tulsa, OK 74105-6317
Phone (918) 712-0859

Other identifiers 1

IdentifierTypeStateIssuer
100746170GMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231223000392 TX Practitioner - Mental Health Counselor 6507216074 Reassigns benefits to 1 organization
I20231227000088 OK Practitioner - Mental Health Counselor 6507216074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Practice addresses (Care Compare)

1800 E Coplin St
Creek Nation Community Hospital
Okemah, OK 74859-4642
Phone (918) 623-1424

Hospital & facility affiliations

  • Creek Nation Community Hospital Hospital, Okemah, OK, CCN 371333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Jan 1, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 1, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 1, 2024 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients

Locations

1800 E Coplin St
Okemah, OK 74859
Phone (918) 623-1424

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

Dept 1467
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Organizations & group practices 4

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": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1750768800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 E SKELLY DR",
            "address_2": "SUITE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056317",
            "telephone_number": "918-712-0859",
            "fax_number": "918-388-6456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E SKELLY DR",
            "address_2": "SUITE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056317",
            "telephone_number": "918-712-0859",
            "fax_number": "918-388-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGHLER",
        "first_name": "TERRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100746170G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.