Individual provider Active NPI

Jennifer Ann Blume, LCSW

  • Counselor
  • Edmond, OK
National Provider Identifier
1922583715
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
7672 Issued in 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
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 4

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6951SDMDCounselor
7672OKMDPediatrics Physician
117663TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackalope Therapy Counselor CurrentSince Nov 9, 2025 Accepting new patients

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": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1922583715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S BOULEVARD STE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135174",
            "telephone_number": "405-215-9151",
            "fax_number": "405-938-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S BOULEVARD STE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135174",
            "telephone_number": "405-215-9151",
            "fax_number": "405-938-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUME",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SD",
            "license": "6951",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "7672",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "117663",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "7672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.