EDWIN WOOLLY – Counselor, NPI 1902039480

EDWIN WOOLLY is a healthcare provider. based in Poteau, Oklahoma. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for EDWIN WOOLLY is 1902039480

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
EDWIN WOOLLY
NPI
1902039480
Phone
(918) 649-0300
Address
2210 N BROADWAY ST
Enumeration Date
31 August 2009
Last Update Date
14 January 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9186490018
Graduation Year
2010 (16 years ago)
PAC ID
8628507027
Group Practice PAC ID
6608272562
Professional Enrollment ID
I20250130001672
Address ID
OK749534400PO204XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:16State licenses:0Digital endpointsOther names

1,199 MENTAL HEALTH COUNSELOR in OK

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Provider Addresses for EDWIN WOOLLY

  • 2210, North Broadway Street, Poteau, LeFlore County, Oklahoma, 74953, United States

    BLD B

    POTEAU, OK 749532000

    Phone: (918) 649-0300

    Fax: (918) 649-0094

    Mailing address matches the actual address.

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: 2025-01-30

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
I20250130001672IMental 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 74953)

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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: 6608272562View full group profile
NameSpecialtyState
Clinical Social WorkerOK
Mental Health CounselorOK
Clinical Social WorkerOK
Mental Health CounselorOK

Reviews

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Frequently asked questions

What identifier follows EDWIN WOOLLY across health systems?
The NPI 1902039480 uniquely identifies EDWIN WOOLLY in U.S. healthcare data.
Should I treat EDWIN WOOLLY as an active provider?
Patients and plans typically see EDWIN WOOLLY as active in the national extract.
How should patients interpret EDWIN WOOLLY's specialty?
The extract shows Counselor for EDWIN WOOLLY. Clinical services aligned with this taxonomy classification.
What geographic area is tied to EDWIN WOOLLY?
EDWIN WOOLLY is associated with Poteau, Oklahoma in the same public data insurers reference.
Who maintains EDWIN WOOLLY's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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