Individual provider Active NPI

Theresa Denise Kloh

  • Counselor
  • Edmond, OK
National Provider Identifier
1912226077
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
16400 Clear Creek Dr
Edmond, OK 73013-1249
Phone
(405) 684-4913
NPI assigned
May 27, 2010
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X OK Primary

Addresses

Primary practice location

16400 Clear Creek Dr
Edmond, OK 73013-1249

Mailing address

16400 Clear Creek Dr
Edmond, OK 73013-1249
Phone (405) 684-4913

Other identifiers 1

IdentifierTypeStateIssuer
200120060AMedicaidOK

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240223003821 OK Practitioner - Mental Health Counselor 3072963685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Homecare Advisors LLCGroup PAC ID 3173877362, 33 clinicians

Practice addresses (Care Compare)

2701 W University Blvd
Durant, OK 74701-2997
Phone (580) 740-4053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Homecare Advisors LLC CurrentSince Jan 1, 2024 Accepting new patients
Focis Counseling Services, Inc. Past Accepting new patients

Locations

2701 W University Blvd
Durant, OK 74701
Phone (580) 740-4053

2488 E 81st St
Ste 485
Tulsa, OK 74137
Phone (918) 392-0804

Organizations & group practices 2

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": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1912226077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 CLEAR CREEK DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131249",
            "telephone_number": "405-684-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 CLEAR CREEK DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131249",
            "telephone_number": "405-684-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOH",
        "first_name": "THERESA",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200120060A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.