Michael Steven Backora
Individual provider Active NPI Mental Health Counselor · Barnsdall, OK
NPI 1831602507 · NPPES record last updated Aug 7, 2020
Key facts
- NPI
- 1831602507
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 401 W. Main St.
Barnsdall, OK 74002-6631 - Phone
- (918) 604-6054
- Fax
- (918) 777-9018
- NPI assigned
- Nov 15, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family and Children'S Services, Inc
Practice addresses (Care Compare)
2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone (918) 712-4301
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240926000059 | OK | Practitioner - Mental Health Counselor | 2769923077 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family & Children'S Services, Inc | Current |
Accepting new patients |
Locations
2325 S Harvard Ave
Tulsa, OK 74114
Phone (918) 921-3200
650 S Peoria Ave
Tulsa, OK 74120
Phone (918) 560-1200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
401 W. Main St.
Barnsdall, OK 74002-6631
Mailing address
401 W. Main St.
Barnsdall, OK 74002-6631
Phone (918) 604-6054
NPI Registry JSON
{
"created_epoch": "1510704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1831602507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 W. MAIN ST.",
"city": "BARNSDALL",
"state": "OK",
"postal_code": "740026631",
"telephone_number": "918-604-6054",
"fax_number": "918-777-9018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W. MAIN ST.",
"city": "BARNSDALL",
"state": "OK",
"postal_code": "740026631",
"telephone_number": "918-604-6054",
"fax_number": "918-777-9018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACKORA",
"first_name": "MICHAEL",
"middle_name": "STEVEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-15",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barnsdall, OK
- Ealisa Adams
- Savanna Blu Aflleje
- Chelsea Janice-Marie Allen
- Kelly Ray Anthony
- Trina Austin
- Barnsdall Health Care, LLC
- Barnsdall School
- Mollie Lorane Barto
- Bigheart, LLC
- Melissa Joann Bouchard
All providers in Barnsdall, OK · Mental Health Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.