Kaitlyn Marie Kipps

Individual provider Active NPI Professional Counselor · Seminole, OK

NPI 1982107645 · NPPES record last updated Apr 12, 2023

Key facts

NPI
1982107645
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
609 E Wrangler Blvd
Seminole, OK 74868-2640
Phone
(405) 380-5033
NPI assigned
Mar 8, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OK
Professional Counselor 101YP2500X Yes

Addresses

Primary practice location

609 E Wrangler Blvd
Seminole, OK 74868-2640

Mailing address

609 E Wrangler Blvd
Seminole, OK 74868-2640
Phone (405) 380-5033

Other names

  • Kaitlyn Marie Goodson Former name

Other providers in Seminole, OK

All providers in Seminole, OK · Professional Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.