MRS. MARY SHANNON HAZEN LCSW
NPI 1043953797
Counselor - Mental Health in Newalla, OK
About Mrs. Mary Shannon Hazen Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. MARY SHANNON HAZEN LCSW (NPI 1043953797) is an individual mental health provider in Newalla, Oklahoma, licensed in Oklahoma (21587) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Choctaw, and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Mary Shannon Hazen Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Mary Hazen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Newalla, OK 74857
- Reassigned Medicare billing, Oklahoma enrollment
- 2 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Oklahoma enrollment
- 45 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Hazen's NPI number?
The NPI number for Mary Hazen is 1043953797. It was assigned to this individual provider in the NPPES registry on April 19, 2022.
Where is Mary Hazen located?
Mary Hazen practices at 5021 Red Hill Rd, Newalla, OK 74857. The listed phone number is (405) 391-7777.
What is Mary Hazen's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Mary Hazen enrolled in Medicare?
Yes. Mary Hazen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Mary Hazen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Hazen reassigns Medicare benefits to 2 organizations: Porchlight Counseling And Consulting LLC (Newalla, OK) and Mental Health Specialty Group PA (Durham, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Hazen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mary Hazen accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Mary Hazen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mary Hazen was last updated on August 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Mary Shannon Hazen, LCSW · NPI 1043953797
Mental Health provider in Newalla, Oklahoma. Individual provider, active in the CMS NPPES registry since April 19, 2022.
## Identity
- **NPI:** 1043953797 (Entity type: Individual)
- **Enumerated:** April 19, 2022
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 21587 (Oklahoma)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 5021 RED HILL RD, Newalla, OK 74857-8834
- **Phone:** (405) 391-7777
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Porchlight Counseling And Consulting LLC (NPI 1437941762, Newalla, OK); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** August 19, 2025
- **Other identifiers:** Medicaid 1881775211 (OK); Other 21587 (OK)
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Source: [NPI Profile](https://npiprofile.com/npi/1043953797) · Data from the CMS NPPES public registry.