Kimberly S Petty, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

10310 N 138TH East Ave Ste 201
Owasso, OK 74055-4641

Phone

(918) 520-1202

Fax

(918) 340-6383

NPI assigned

Sep 3, 2008

Last updated

Dec 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Master of Science

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.

• Improving Lives Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1487967444
  Medicare reassignment NPD
• Embrace Life Counseling LLC

  • Professional Counselor
  • Owasso, OK
  • NPI 1952881427
  NPD Authorized official

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1881842870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10310 N 138TH EAST AVE STE 201",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554641",
            "telephone_number": "918-520-1202",
            "fax_number": "918-340-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10310 N 138TH EAST AVE STE 201",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554641",
            "telephone_number": "918-520-1202",
            "fax_number": "918-340-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881842870",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Perkins
• Gerri Perkins, PHARM.D.
• Natalie Permaul
• Dara Peterson, RN
• Garth Peterson
• Roger K Pfeiffer, D.O.
• Pharmacy Providers Inc
• Tracy Nicole Phillip
• PHP Ok PC (Primary Health Partners)
• Shaylon Phy

• Mental Health Counselor in Owasso, OK
• Providers in Owasso, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.