Mary E Summers, BS/BHRS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6100 Issued in OK

Practice address

4122 W 55TH Place S.
Suite 119
Tulsa, OK 74107-9108

Phone

(918) 486-9996

Fax

(800) 260-7966

NPI assigned

Aug 19, 2013

Last updated

Mar 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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.

• Grand Lake Mental Health Center, Inc.

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520
  Medicare reassignment NPD
• Grand Lake Mental Health Center, Inc.

  dba Grand Lake Medical Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pryor, OK
  • NPI 1063817021
  NPD
• Grand Lake Mental Health Center, Inc.

  dba Grand Mental Health

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1841623444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 W DETROIT ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122183",
            "telephone_number": "918-361-4664",
            "fax_number": "800-260-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 W 55TH PLACE S.",
            "address_2": "SUITE 119",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741079108",
            "telephone_number": "918-486-9996",
            "fax_number": "800-260-7966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 E Skelly Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741056344",
            "country_code": "US",
            "telephone_number": "888-882-0859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "BS/BHRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "OK",
            "license": "BHRS CERTIFICATION",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "6100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katlynn Summers
• Kayli Nicole Summers, B.A
• Kyle Franklin Summers, D.O.
• Kylee Alyse Summers, DPT
• Leighton Summers
• Nakisha Nicole Summers
• Norman Lewis Summers, LCSW
• Rachel Ann Summers, ARNP-CNP
• Valerie Summers
• Catherine Elizabeth Summerson

• Professional Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.