LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS (NPI# 1649796590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649796590 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS |
| Practice Address |
2530 S Commerce St Bldg C Ardmore OK 73401-5519 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 5802265048 |
| Practice Fax Number | 5802263569 |
| Mailing Telephone | 5802235070 |
| Mailing Fax Number | 5802235617 |
| Enumeration Date | 2017-08-22 |
| 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 | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
4157 | OK | 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 |
| 1013542190 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 2425 W University Blvd, Durant, OK 74701-2970 | 2020-03-09 |
| 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 |
2530 S COMMERCE ST BLDG C |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-5519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124323746 | Jobrena Tucker | Counselor | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2011-01-12 |
| 1487285300 | Shelley J Jones | Counselor | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2020-01-29 |
| 1174017636 | Jodi Lynn Woydziak | Case Manager/Care Coordinator | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2018-06-19 |
| 1215426374 | Doreen Jo Saffle | Case Manager/Care Coordinator | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2018-05-04 |
| 1831615525 | Matthew Honeycutt | Peer Specialist | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2017-08-15 |
| 1548617269 | Chloe Richards | Counselor | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2016-05-23 |
| 1205211505 | Michele Roberts | Case Manager/Care Coordinator | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2015-07-28 |
| 1932518024 | Jorie Harris | Counselor | 2530 S Commerce St Bldg C, Ardmore, OK 73401-5519 | 2014-08-04 |
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508963406 | Craig Steven Tutton | Psychiatry & Neurology | 1212 Merrick Drive, Ardmore, OK 73401 | 2006-09-20 |
| 1609980937 | Craig S Tutton Md, Inc PC | Psychiatry & Neurology | 1212 Merrick Dr, Ardmore, OK 73401-1824 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528512183 | Olive Branch Psychiatry | Psychiatry & Neurology | 1900 E 15th St Ste C, Edmond, OK 73013 | 2016-08-11 |
| 1316176340 | Andrew Hyun Liew | Psychiatry & Neurology | 4444 E 41st St Fl 3, Tulsa, OK 74135-2527 | 2009-07-13 |
| 1285775759 | Sridevi Nagumalli | Psychiatry & Neurology | 705 Scottsbluff, Norman, OK 73072-4835 | 2007-02-09 |
| 1851475198 | Sylvia J Turner | Psychiatry & Neurology | Dept. of The Army; Usameddac, Attn: Mcua-cmh: Dr.sylvia Turner, Fort Sill, OK 73505-6300 | 2006-10-24 |
| 1285640102 | Chariny Michelle Herring | Psychiatry & Neurology | 2530 E 71st St Ste B, Tulsa, OK 74136-5577 | 2006-07-31 |
| 1235166364 | Michelle Marie Holloway | Psychiatry & Neurology | 2129 Sw 59th Street, Oklahoma City, OK 73159-7024 | 2006-06-26 |
| 1366427478 | Robyn Cowperthwaite | Psychiatry & Neurology | 4200 W Memorial Rd Ste 503, Oklahoma City, OK 73120-8305 | 2005-12-12 |
| 1225022924 | Linda K Ramer | Psychiatry & Neurology | 2601 Spencer Rd, Spencer, OK 73084-3649 | 2005-09-08 |
| 1033103304 | Ethan D Lindsey | Psychiatry & Neurology | 1117 Nw 50th St, Oklahoma City, OK 73118-4401 | 2005-09-01 |
| 1508487646 | Balance Psychiatry & Wellness Pllc | Psychiatry & Neurology | 1218 E 9th St Ste 4, Edmond, OK 73034-5796 | 2020-04-29 |
| 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.