GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1609249390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609249390 |
| Entity Type | Organization |
| Organization Name | GRAND LAKE MENTAL HEALTH CENTER, INC. |
| Other Organization Name | GRAND LAKE MEDICAL HEALTH CENTER |
| Practice Address |
401 W Main St Barnsdall OK 74002 |
| Mailing Address |
114 W Delaware Ave Nowata OK 74048-2601 |
| Practice Telephone | 9183378080 |
| Practice Fax Number | 9183378099 |
| Mailing Telephone | 9182731841 |
| Mailing Fax Number | 9182731843 |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2020-07-31 |
| Authorized Official Name | LARRY SMITH (CEO) |
| Authorized Official Telephone | 9182731841 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Grand Lake Medical Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912531344 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 3186 W Highway 412, West Siloam Springs, OK 74338-1356 | 2020-02-25 |
| 1760022602 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1010 Harbor Rd, Grove, OK 74344-5147 | 2020-01-08 |
| 1932749876 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 211 N Hwy 10 Ste D, Kansas, OK 74347-0000 | 2020-01-08 |
| 1487201133 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 7307 S Yale Ave, Suite 101, Tulsa, OK 74136-7134 | 2019-08-19 |
| 1114458858 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 211 N. Hwy 59 Ste A and B, Kansas, OK 74347-7607 | 2017-03-24 |
| 1598216087 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1010 Harber Rd, Grove, OK 74344-5147 | 2016-10-19 |
| 1003292061 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 | 2015-07-31 |
| 1114269917 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 9432 N. May Ave, Suite D, Oklahoma City, OK 73120-2723 | 2013-03-20 |
| 1104167204 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 9430 N May Ave, Oklahoma City, OK 73120-2712 | 2013-03-14 |
| 1922017060 | Grand Lake Mental Health Center, Inc. | Case Management | 513 S Quapaw Ave, Bartlesville, OK 74003-4331 | 2006-08-07 |
| Street Address |
401 W MAIN ST |
| City | BARNSDALL |
| State | OK |
| Zip Code | 74002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047330 | Gabriele Dawn Barrone | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002-6631 | 2020-03-07 |
| 1912547852 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 401 W Main St, Barnsdall, OK 74002-6631 | 2020-01-08 |
| 1831749787 | Shalena Diane Pece | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002 | 2019-09-12 |
| 1023662343 | Destiny A Ritchie | Counselor | 401 W Main St, Barnsdall, OK 74002-6631 | 2019-07-25 |
| 1386296176 | Crala Marlin | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002 | 2019-07-11 |
| 1639738990 | Frances Kay Garrett | Peer Specialist | 401 W Main St, Barnsdall, OK 74002-6631 | 2019-06-11 |
| 1710542956 | Danielle Antle | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002-6631 | 2019-05-02 |
| 1376000554 | Jeana Reed | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002 | 2019-02-25 |
| 1649706771 | Leisa James | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002-0000 | 2017-05-10 |
| 1346783123 | Savanna Blu Aflleje | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002-0000 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073165866 | Chelsea Janice-marie Allen | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002 | 2019-07-11 |
| 1841648953 | Haley Perkins | Case Manager/Care Coordinator | 401 W, Main, Barnsdall, OK 74002 | 2016-05-31 |
| 1205218146 | Megan Hudson | Social Worker | 401 W Main St., Barnsdall, OK 74002 | 2015-06-28 |
| 1801078621 | Lura Lea Jaquess | Social Worker | 609 Cedar Ave., Barnsdall, OK 74002 | 2007-12-04 |
| 1659393015 | Jill Suzanne Sago | Counselor | 401 W. Main St., Barnsdall, OK 74002 | 2006-07-24 |
| 1881686186 | Marcus D Sizemore | Physician Assistant | 112 N 5th, Barnsdall, OK 74002 | 2005-08-22 |
| 1740822493 | Andrea Cousparis | Social Worker | 401 West Main Street, Barnsdall, OK 74002 | 2019-10-15 |
| 1790335644 | Hanna Grace Stroup | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002 | 2019-09-12 |
| 1891352290 | Mason Allan Moody | Case Manager/Care Coordinator | 401 W. Main St, Barnsdall, OK 74002 | 2019-05-22 |
| 1568027951 | Amber Quillin | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002 | 2019-05-01 |
| Find all providers in zip 74002 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912547852 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 401 W Main St, Barnsdall, OK 74002-6631 | 2020-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870742 | Sequelcare of Oklahoma, LLC | Clinic/Center | 6218 S Lewis Ave Ste 118, Tulsa, OK 74136-1018 | 2020-10-28 |
| 1649870890 | M & M Counseling Group, LLC | Clinic/Center | 207 S Czech Hall Rd, Yukon, OK 73099-6851 | 2020-10-27 |
| 1992303721 | Misty Watkins | Clinic/Center | 1601 Sw Parkridge Blvd Ste 200, Lawton, OK 73505-7564 | 2020-10-14 |
| 1295342046 | Integrative Healthcare Solutions LLC | Clinic/Center | 2227 E 8th St, Tulsa, OK 74104-3237 | 2020-09-25 |
| 1235744020 | Strength of A Warrior Counseling Services LLC | Clinic/Center | 4516 Se 25th St, Del City, OK 73115-4114 | 2020-09-09 |
| 1609488253 | Alexie Foster, LLC | Clinic/Center | 16802 S 301st West Ave, Bristow, OK 74010-2265 | 2020-08-17 |
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1245855857 | Dragonfly Psychotherapy | Clinic/Center | 2942 Ne Orlie Dr, Forest Park, OK 73121-2436 | 2020-06-09 |
| 1508480872 | Maria Nancy Martinez | Clinic/Center | 5350 S Western Ave Ste 217, Oklahoma City, OK 73109-4525 | 2020-06-03 |
| 1649894015 | Miranda Rackers | Clinic/Center | 1308 E Mckinley Ave, Sapulpa, OK 74066-4824 | 2020-06-02 |
| Find all providers with the same taxonomy | ||||
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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.