Jennifer Ann Blume, LCSW

Individual provider Active NPI Counselor · Edmond, OK

NPI 1922583715 · NPPES record last updated Apr 14, 2026

Key facts

NPI
1922583715
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
License
7672 (OK)
Practice address
1700 S Boulevard Ste B
Edmond, OK 73013-5174
Phone
(405) 215-9151
Fax
(405) 938-0988
NPI assigned
Sep 27, 2018
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6951SDMDCounselor
7672OKMDPediatrics Physician
117663TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackalope Therapy Counselor Current
since Nov 9, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6951 SD
Clinical Social Worker 1041C0700X 7672 OK
Counselor 101Y00000X 117663 TX
Counselor 101Y00000X 7672 OK Yes

Addresses

Primary practice location

1700 S Boulevard Ste B
Edmond, OK 73013-5174

Mailing address

1700 S Boulevard Ste B
Edmond, OK 73013-5174
Phone (405) 215-9151

Other providers in Edmond, OK

All providers in Edmond, OK · Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.