Healthcare Provider Details

I. General information

NPI: 1922127000
Provider Name (Legal Business Name): MARY JO POPE MSHR, LPC, LADC, CM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E MONROE AVE
MCALESTER OK
74501-4815
US

IV. Provider business mailing address

530 W TAYLOR AVE
MCALESTER OK
74501-3450
US

V. Phone/Fax

Practice location:
  • Phone: 918-426-7858
  • Fax: 918-426-5526
Mailing address:
  • Phone: 918-426-7858
  • Fax: 918-426-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3336
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number363
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: