Active NPI
Kenneth D. Contrereas, LPC
- Professional Counselor
- Tulsa, OK
National Provider Identifier
1942539135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1247
- Practice address
- 6218 S Lewis Ave
Suite 115
Tulsa, OK 74136-1018 - Phone
- (918) 231-3995
- Fax
- (918) 747-0164
- NPI assigned
- Dec 16, 2009
- Last updated
- Aug 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1247 | OK | Primary |
Addresses
Primary practice location
6218 S Lewis Ave
Suite 115
Tulsa, OK 74136-1018
Mailing address
10349 S 156TH West Ave
Sapulpa, OK 74066-9208
Phone (918) 231-3995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1247 | OK | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282780800000",
"number": "1942539135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10349 S 156TH WEST AVE",
"city": "SAPULPA",
"state": "OK",
"postal_code": "740669208",
"telephone_number": "918-231-3995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6218 S LEWIS AVE",
"address_2": "SUITE 115",
"city": "TULSA",
"state": "OK",
"postal_code": "741361018",
"telephone_number": "918-231-3995",
"fax_number": "918-747-0164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONTREREAS",
"first_name": "KENNETH",
"middle_name": "D.",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-16",
"last_updated": "2010-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "1247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.