Active NPI
Charles Corbin Humble, MA, LPC
- Professional Counselor
- Bethany, OK
National Provider Identifier
1982920583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3981
- Practice address
- 3908 N Peniel Ave Ste 500
Bethany, OK 73008-3402 - Phone
- (405) 808-7180
- NPI assigned
- Apr 8, 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 | 3981 | OK | Primary |
Addresses
Primary practice location
3908 N Peniel Ave Ste 500
Bethany, OK 73008-3402
Mailing address
3908 N Peniel Ave Ste 500
Bethany, OK 73008-3402
Phone (405) 808-7180
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200318120A | Medicaid | OK | |
| 200318120B | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 16, 2024 through Aug 16, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3981 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562198400000",
"number": "1982920583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3908 N PENIEL AVE STE 500",
"city": "BETHANY",
"state": "OK",
"postal_code": "730083402",
"telephone_number": "405-808-7180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3908 N PENIEL AVE STE 500",
"city": "BETHANY",
"state": "OK",
"postal_code": "730083402",
"telephone_number": "405-808-7180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMBLE",
"first_name": "CHARLES",
"middle_name": "CORBIN",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-08",
"last_updated": "2019-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "3981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200318120A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200318120B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethany, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.