Tara Martin
Individual provider Active NPI Mental Health Counselor · Soper, OK
NPI 1922421098 · NPPES record last updated Dec 6, 2017
Key facts
- NPI
- 1922421098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- HC 71 Box 1a
Soper, OK 74759-9721 - Phone
- (580) 317-5533
- NPI assigned
- Jan 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
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 |
|---|---|---|---|---|
| I20240917004778 | OK | Practitioner - Mental Health Counselor | 3971044959 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brighter Heights Oklahoma, LLC | Current |
Accepting new patients | |
| Serenity Behavioral Services, PLLC | Mental Health | Current |
Accepting new patients |
| Brighter Heights Oklahoma, LLC | Current |
Accepting new patients | |
| Mental Health Specialty Group PA | Mental Health | Current |
Accepting new patients |
Locations
301 N High St
Antlers, OK 74523
Phone (580) 271-7055
107 S High St
Antlers, OK 74523
Phone (580) 298-2830
101 Park Ave
Oklahoma City, OK 73102
Phone (405) 442-4940
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
HC 71 Box 1a
Soper, OK 74759-9721
Mailing address
PO Box 102
Bennington, OK 74723-0102
Phone (580) 317-5533
Other providers in Soper, OK
All providers in Soper, 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 Dec 6, 2017. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.