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VICTORIA D MEDLOCK LPC
NPI 1689938342
Counselor - Mental Health in Pryor, OK

Active since June 27, 2012PECOS EnrolledAccepts Medicare Assignment
109 N FAIRLAND ST, PRYOR, OK 74361(918) 825-1405(918) 825-1406 Get Directions Write a Review

NPPES record last updated: April 8, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 8, 2019, Mar 13, 2017 (2 updates tracked since 2017).

About Victoria D Medlock Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICTORIA D MEDLOCK LPC (NPI 1689938342) is an individual mental health provider in Pryor, Oklahoma, licensed in Oklahoma (7046) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1689938342
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameVICTORIA D MEDLOCKCredential: LPC
Location Address109 N FAIRLAND STPryor, OK 74361-4203
Mailing Address109 N Fairland StPryor, OK 74361-4203 · (918) 825-1405 · Fax (918) 825-1406
Phone(918) 825-1405
Fax(918) 825-1406
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 27, 2012
Last NPPES UpdateApril 8, 20192 updates tracked since enumeration
✔ NPI 1689938342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OK · 7046
109 N FAIRLAND ST, Pryor, OK 74361
Open in Google Maps ↗

Other Identifiers 1

Medicaid200226970AOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.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

Victoria D Medlock Lpc 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.

PECOS PAC ID9931558400
PECOS Enrollment IDI20231208001785
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Victoria Medlock reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grand Lake Mental Health Center, Inc.
Same address
Mental Health (Including Community Mental Health Center)
109 N FAIRLAND ST
Pryor, OK 74361
  • Reassigned Medicare billing, Oklahoma enrollment
  • 333 clinicians in this Medicare group
NPI 1063817021 (918) 825-1405

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 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KALI ROSE KERNS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
JACKIE ELAINE HORTON
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
WHITNEY JOANNA PHILLIPS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
BREANNA NICOLE COOK MHR, LPC-C
Counselor (Mental Health)
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1401
NICOLE BURNHAM LPN
Licensed Practical Nurse
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
STEPHANIE RENEE STACY
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841
CRYSTAL MICHELLE CUMMINS
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
KANDICE BRIANS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841

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 Victoria Medlock's NPI number?

The NPI number for Victoria Medlock is 1689938342. It was assigned to this individual provider in the NPPES registry on June 27, 2012.

Where is Victoria Medlock located?

Victoria Medlock practices at 109 N Fairland St, Pryor, OK 74361. The listed phone number is (918) 825-1405.

What is Victoria Medlock's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Victoria Medlock enrolled in Medicare?

Yes. Victoria Medlock 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 organization bills Medicare for Victoria Medlock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Victoria Medlock reassigns Medicare benefits to Grand Lake Mental Health Center, Inc. (Pryor, OK). The 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 Victoria Medlock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Victoria Medlock accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Victoria Medlock 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 Victoria Medlock was last updated on April 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.