Individual provider Active NPI

Cassandra Kaye Kemp

  • Counselor
  • Tulsa, OK
National Provider Identifier
1972862589
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1 W 36TH St N Ste 202
Tulsa, OK 74106-1700
Phone
(918) 425-4200
Fax
(918) 425-4201
NPI assigned
May 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

1 W 36TH St N Ste 202
Tulsa, OK 74106-1700

Mailing address

11309 E 36TH St
Tulsa, OK 74146-2802
Phone (918) 949-7801

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
I20240205002795 OK Practitioner - Mental Health Counselor 0749623965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family and Children'S Services, IncGroup PAC ID 9830170687, 63 clinicians

Practice addresses (Care Compare)

650 S Peoria Ave
Tulsa, OK 74120-4429
Phone (918) 587-9471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1303OKMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children'S Services, Inc CurrentSince Jan 1, 2024 Accepting new patients
Creoaks Behavioral Health Services Past Accepting new patients

Locations

650 S Peoria Ave
Tulsa, OK 74120
Phone (918) 560-1200

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1972862589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11309 E 36TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741462802",
            "telephone_number": "918-949-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W 36TH ST N STE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741061700",
            "telephone_number": "918-425-4200",
            "fax_number": "918-425-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "CASSANDRA",
        "middle_name": "KAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.