Individual provider Active NPI

Kristen Diane Perry, LPC

  • Mental Health Counselor
  • Oklahoma City, OK
National Provider Identifier
1982178299
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7688 Issued in OK
Practice address
5705 NW 132ND St
Oklahoma City, OK 73142-4437
Phone
(405) 694-5732
NPI assigned
Jan 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 7688 OK Primary

Addresses

Primary practice location

5705 NW 132ND St
Oklahoma City, OK 73142-4437

Mailing address

5705 NW 132ND St
Oklahoma City, OK 73142-4437
Phone (405) 694-5732

Other identifiers 1

IdentifierTypeStateIssuer
101YM0800XMedicaidOK

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
I20251013001915 OK Practitioner - Mental Health Counselor 6406343607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vivify CounselingGroup PAC ID 3779070974, 2 clinicians

Practice addresses (Care Compare)

9950 Stone Crest Cir
Edmond, OK 73034-6608
Phone (405) 694-5732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7688OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vivify Counseling Mental Health CurrentSince Nov 1, 2021 Accepting new patients
Concepts in Counseling, LLC Past Accepting new patients

Locations

5705 NW 132nd St
Oklahoma City, OK 73142
Phone (405) 250-4158

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": "1547942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1982178299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 NW 132ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731424437",
            "telephone_number": "405-694-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 NW 132ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731424437",
            "telephone_number": "405-694-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KRISTEN",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-20",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "7688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.