Individual provider Active NPI

Christa Nelson

  • Professional Counselor
  • Mannford, OK
National Provider Identifier
1861890501
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10025 Issued in OK
Practice address
5725 S 391St West Ave
Mannford, OK 74044-6013
Phone
(918) 237-8019
NPI assigned
Dec 11, 2014
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OK
Professional Counselor 101YP2500X 10025 OK Primary

Addresses

Primary practice location

5725 S 391St West Ave
Mannford, OK 74044-6013

Mailing address

5725 S 391St West Ave
Mannford, OK 74044-6013
Phone (918) 237-8019

Other practice location 1

3015 E Skelly Dr Ste 103
Tulsa, OK 74105-6344
Phone (888) 882-0859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 29, 2025 through Dec 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10025OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C. Alan Bentley Counseling LLC Professional 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": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1861890501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 S 391ST WEST AVE",
            "city": "MANNFORD",
            "state": "OK",
            "postal_code": "740446013",
            "telephone_number": "918-237-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 S 391ST WEST AVE",
            "city": "MANNFORD",
            "state": "OK",
            "postal_code": "740446013",
            "telephone_number": "918-237-8019"
        }
    ],
    "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",
            "fax_number": "918-388-9708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CHRISTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "10025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mannford, OK

Sources for this page

Verify at the official NPI Registry.