LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS (NPI# 1013542190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013542190 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS |
| Practice Address |
2425 W University Blvd Durant OK 74701-2970 |
| Mailing Address |
2425 W University Blvd-ste 100 Durant OK 74701-2970 |
| Practice Telephone | 5809247331 |
| Practice Fax Number | 5809247332 |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | DEANA THARP (DEPUTY EXECUTIVE DIRECTCOR) |
| Authorized Official Telephone | 5803197305 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100728830 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740672880 | Lighthouse Behavioral Wellness Centers | Clinic/Center | 2425 W University Blvd Ste 100, Durant, OK 74701-2970 | 2015-02-26 |
| 1225378623 | Lighthouse Behavioral Wellness Centers | Community/Behavioral Health | 1219 K St Nw, Ste. #2, Ardmore, OK 73401-1801 | 2013-02-21 |
| 1033265764 | Lighthouse Behavioral Wellness Centers | Clinic/Center | 301 W 4th St, Ada, OK 74820-3411 | 2007-01-26 |
| 1912053612 | Lighthouse Behavioral Wellness Centers | Clinic/Center | 2530 S Commerce, Bldg B, Ardmore, OK 73401 | 2007-01-26 |
| 1427104546 | Lighthouse Behavioral Wellness Centers | Clinic/Center | 2425 W University Blvd Ste 102, Durant, OK 74701-2970 | 2007-01-25 |
| 1598370298 | Lighthouse Behavioral Wellness Centers | Community/Behavioral Health | 414 W Muskogee Ave, Sulphur, OK 73086-4614 | 2020-09-10 |
| 1649796590 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2017-08-22 |
| 1154747384 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 1000 S Byrd St, Tishomingo, OK 73460-3265 | 2014-03-12 |
| 1720404932 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2014-03-12 |
| 1285050492 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 2010 Boren Blvd, Seminole, OK 74868-2050 | 2014-03-12 |
| Street Address |
2425 W UNIVERSITY BLVD |
| City | DURANT |
| State | OK |
| Zip Code | 74701-2970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518087899 | Charles W Bachmann IIi | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-03-30 |
| 1316546104 | Nathan Starry | Case Manager/Care Coordinator | 2425 W University Blvd, Durant, OK 74701-2942 | 2020-10-22 |
| 1093349003 | Mental Health Service of Southern Oklahoma | Community/Behavioral Health | 2425 W University Blvd, Durant, OK 74701-2942 | 2020-02-28 |
| 1649454273 | Kenneth L. Cone Dds, PC | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-12-18 |
| 1598949125 | Charles W. Bachmann IIi, Dds PC | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-12-18 |
| 1205956521 | Dental Associates of Durant, Pllc | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053403501 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Psychiatry & Neurology | 4444 E. 41st St, 3rd Floor, Ste C, Ou Physicians Tulsa Psychiatry, Tulsa, OK 74125-2527 | 2006-09-29 |
| 1801436035 | Vizion LLC | Psychiatry & Neurology | 102 E Steve Owens Blvd, Miami, OK 74354-7730 | 2020-01-15 |
| 1982976742 | Richard Zielinski Md, Pllc | Psychiatry & Neurology | 712 W 3rd St, Watonga, OK 73772 | 2012-02-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.