Individual provider Active NPI

Jennifer Elaine Wilburn, MS LPC LADC

  • Addiction (Substance Use Disorder) Counselor
  • Tulsa, OK
National Provider Identifier
1801019955
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
495 Issued in OK
Practice address
4845 S Sheridan Rd
Suite 510
Tulsa, OK 74145-5751
Phone
(918) 384-0002
Fax
(918) 384-0004
NPI assigned
Apr 10, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 495 OK Primary
Professional Counselor 101YP2500X 3344 OK

Addresses

Primary practice location

4845 S Sheridan Rd
Suite 510
Tulsa, OK 74145-5751

Mailing address

4845 S Sheridan Rd
Suite 510
Tulsa, OK 74145-5751
Phone (918) 384-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
495OKMDMarriage & Family Therapist
3344OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindset Behavioral Health PLLC Past Accepting new patients

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1801019955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 S SHERIDAN RD",
            "address_2": "SUITE 510",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741455751",
            "telephone_number": "918-384-0002",
            "fax_number": "918-384-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 S SHERIDAN RD",
            "address_2": "SUITE 510",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741455751",
            "telephone_number": "918-384-0002",
            "fax_number": "918-384-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN",
        "first_name": "JENNIFER",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "MS LPC LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "495",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.