LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS (NPI# 1225378623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225378623 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS |
| Practice Address |
1219 K St Nw Ste. #2 Ardmore OK 73401-1801 |
| Practice Telephone | 5807984523 |
| Practice Fax Number | 5803195349 |
| Mailing Telephone | 5807984523 |
| Mailing Fax Number | 5803195349 |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | DEANA THARP (DEPUTY EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5803197305 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 100728830 | OK | Agencies |
| 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 |
| 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 |
| 1013542190 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 2425 W University Blvd, Durant, OK 74701-2970 | 2020-03-09 |
| 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 |
1219 K ST NW STE. #2 |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962035493 | Lori J Heilbrun | Case Manager/Care Coordinator | 1219 K St Nw, Ardmore, OK 73401-1801 | 2020-02-12 |
| 1710519822 | Julie Shoemake | Behavior Technician | 1219 K St Nw, Ardmore, OK 73401-1801 | 2020-02-06 |
| 1326679358 | Nannette Arlien Purifoy | Case Manager/Care Coordinator | 1219 K St Nw, Ardmore, OK 73401-1801 | 2020-01-29 |
| 1376173633 | Bianca Hamilton | Case Manager/Care Coordinator | 1219 K St Nw, Ardmore, OK 73401-1801 | 2020-01-24 |
| 1164060075 | Naomi Brown | Case Management | 1219 K St Nw, Ardmore, OK 73401-1801 | 2019-12-11 |
| 1619525813 | Rita Ann Zimmerman | Case Manager/Care Coordinator | 1219 K St Nw, Ardmore, OK 73401-1801 | 2019-08-30 |
| 1386113504 | Meagan Rachelle Fowler | Technician | 1219 K St Nw, Ardmore, OK 73401-1801 | 2018-11-16 |
| 1750865531 | Timothy Wayne Ramsey | Peer Specialist | 1219 K St Nw, Ardmore, OK 73401-1801 | 2018-09-18 |
| 1689170060 | Sierra Lorene Gaines | Specialist/Technologist | 1219 K St Nw, Ardmore, OK 73401-1801 | 2018-04-04 |
| 1851893523 | David James Tolbert | Technician | 1219 K St Nw, Ardmore, OK 73401-1801 | 2018-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356879928 | Melissa Hammel Consulting | Community/Behavioral Health | 30267 Highland Dr, Ardmore, TN 38449-3216 | 2017-05-26 |
| 1366832800 | Alicia Chastain | Community/Behavioral Health | 1301 7th Ave Nw, Ardmore, OK 73401-2469 | 2015-02-04 |
| 1346665288 | Johnny D Green Mshr, Lpc,pc | Community/Behavioral Health | 597 Colt Ln, Ardmore, OK 73401-9138 | 2014-03-01 |
| 1992141501 | Shawnda Shana Mawell | Community/Behavioral Health | 1215 11th Ave Ne, Ardmore, OK 73401-7019 | 2013-05-22 |
| 1790042117 | Southeastern Oklahoma Family Services, Inc. | Community/Behavioral Health | 34 N Washington St, Ardmore, OK 73401-7013 | 2012-04-23 |
| 1346575883 | Southeastern Oklahoma Family Services, Inc. | Community/Behavioral Health | 115 W Broadway St Ste 401, Ardmore, OK 73401-6210 | 2009-10-15 |
| 1831424787 | Kk Ounseling, Inc. | Community/Behavioral Health | 74 Overland Route St, Ardmore, OK 73401-2916 | 2009-10-10 |
| 1922266964 | Mental Health Services of Southern Oklahoma | Community/Behavioral Health | #2 Broadlawn, Ardmore, OK 73402-1722 | 2008-05-27 |
| 1508052713 | New Restoration Counseling Center | Community/Behavioral Health | 115 W Main St Ste 406, Ardmore, OK 73401-6413 | 2007-09-20 |
| 1841498078 | Family Shelter of Southern Oklahoma for Victims of Domestic Violence | Community/Behavioral Health | 116 C St Sw, Ardmore, OK 73401-6304 | 2007-07-10 |
| Find all providers in ARDMORE | ||||
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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.