JESSICA KING (MS, LPC) – Professional Counselor, NPI 1063880490

JESSICA KING (MS, LPC) is a healthcare provider. based in Ada, Oklahoma. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MS, LPC. They hold a License No. 6701 (OK). The NPI Number for JESSICA KING (MS, LPC) is 1063880490

Main info

Female
Sole Proprietor
11 Years Of Experience
Name
JESSICA KING (MS, LPC)
NPI
1063880490
Phone
(580) 436-7120
Address
2100 N BROADWAY AVE
Enumeration Date
2 September 2015
Last Update Date
16 May 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5804367120
Graduation Year
2015 (11 years ago)
PAC ID
1355799396
Group Practice PAC ID
9739480955
Professional Enrollment ID
I20231130002864
Address ID
OK748201048AD2100XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,199 MENTAL HEALTH COUNSELOR in OK

Provider Addresses for JESSICA KING (MS, LPC)

  • 2100 N BROADWAY AVE

    ADA, OK 748201048

    Phone: (580) 436-7120

    Type: Location

  • 2102 N Broadway Ave

    Ada, OK 748201048

    Phone: (580) 453-1835

    Type: Location

  • 2102 N BROADWAY AVE

    ADA, OK 748201048

    Phone: (580) 453-1835

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231130002864IMental Health CounselorOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74820)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739480955View full group profile
NameSpecialtyState
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK
Clinical Social WorkerOK
Mental Health CounselorOK
Mental Health CounselorOK
Clinical Social WorkerTX
Mental Health CounselorOK
Mental Health CounselorOK

Reviews

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Frequently asked questions

How do payers reference JESSICA KING (MS, LPC)?
For JESSICA KING (MS, LPC), use NPI 1063880490 as the unique 10-digit identifier.
Is JESSICA KING (MS, LPC) shown as active in public data?
Registry records indicate JESSICA KING (MS, LPC) maintains an active NPI.
What expertise is attributed to JESSICA KING (MS, LPC)?
JESSICA KING (MS, LPC)'s specialty line reads Professional Counselor. Clinical services aligned with this taxonomy classification.
Is JESSICA KING (MS, LPC) located near Ada?
JESSICA KING (MS, LPC) currently maps to Ada, Oklahoma in this extract.
Can I trust this NPI listing for JESSICA KING (MS, LPC)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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