LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS (NPI# 1720404932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720404932 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS |
| Practice Address |
109 S Willow St Pauls Valley OK 73075-3833 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 4052387311 |
| Practice Fax Number | 4052383530 |
| Mailing Telephone | 5802235070 |
| Mailing Fax Number | 5802235617 |
| Enumeration Date | 2014-03-12 |
| 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 | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
100728830 | 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 |
| 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 |
| 1285050492 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 2010 Boren Blvd, Seminole, OK 74868-2050 | 2014-03-12 |
| Street Address |
109 S WILLOW ST |
| City | PAULS VALLEY |
| State | OK |
| Zip Code | 73075-3833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538248992 | Edward James Seeley | Counselor | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2006-11-04 |
| 1528667680 | Amy Holland | Peer Specialist | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2020-10-20 |
| 1174140883 | Michelle Elaine Rutherford | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2020-06-29 |
| 1326697459 | Elmira Louise Johnson | Peer Specialist | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2019-09-11 |
| 1538727136 | Sarah Marie Stone | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075 | 2019-05-30 |
| 1457916025 | Natasha Lynnette Green | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2019-05-08 |
| 1275007122 | Chelsea Ann Triplett | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2019-01-14 |
| 1528546629 | Vanessa Dale Cothren | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2018-07-31 |
| 1912423195 | Hannah Marie Maness | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2017-08-18 |
| 1437695947 | Kathlyn Milligan | Counselor | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2017-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292490 | Jennifer Lynn Reicosky | Counselor | 513 Willow, Pauls Valley, OK 73075 | 2018-10-25 |
| 1336467299 | Fred Lee Mcginn Iv | Counselor | Atlc, 111 Arrowhead Dr., Pauls Valley, OK 73075 | 2010-05-17 |
| 1447435433 | Amanda Marie Hammonds | Physical Therapist | 37915 Ecr 1530, Pauls Valley, OK 73075 | 2008-01-08 |
| 1255533873 | Ladonna L.l. Lynnell Luckey | Counselor | 111 Arrowhead Drive, Adolescent Transitional Living Center, Pauls Valley, OK 73075 | 2007-06-05 |
| 1144369026 | James Ray Ward | Dentist | 112 N Oak, Pauls Valley, OK 73075 | 2007-02-06 |
| 1700953247 | Stanley Family Chiropractic PC | Chiropractor | 1555 W Grant, Pauls Valley, OK 73075 | 2006-11-29 |
| 1659458412 | Woodlawn, LLC | Respite Care | 1413 S. Chickasha, Pauls Valley, OK 73075 | 2006-11-01 |
| 1689750457 | Dana J Martin Dds PC | Dentist | 1600 Airline Road, Pauls Valley, OK 73075 | 2006-10-27 |
| 1609963800 | State of Oklahoma Dept. of Human Services | Pharmacy | Rt 1 Box 44a, Pauls Valley, OK 73075 | 2006-10-07 |
| 1295828895 | State of Oklahoma Dept. of Human Services | Intermediate Care Facility, Mentally Retarded | Rt. 1 Box 44-a, Pauls Valley, OK 73075 | 2006-10-02 |
| Find all providers in zip 73075 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164062253 | Tabor Behavioral Health LLC | Psychiatry & Neurology | 2615 Ridgeway St, Ardmore, OK 73401-2901 | 2020-01-07 |
| 1134783863 | Sarah Thi Tran | Psychiatry & Neurology | 4444 E 41st St Ste B, Tulsa, OK 74135-2527 | 2019-04-29 |
| 1356828305 | Dr. Peteryne D. Miller, M.d. LLC | Psychiatry & Neurology | 4870 S Lewis Ave Ste 205, Tulsa, OK 74105-5153 | 2018-07-23 |
| 1457852659 | Mindful Psychiatry, PC | Psychiatry & Neurology | 5014 E 101st St Ste 200, Tulsa, OK 74137-5803 | 2018-02-22 |
| 1700385481 | Reeder Psychiatry Pllc | Psychiatry & Neurology | 2515 Nw 16th St, Oklahoma City, OK 73107-4839 | 2018-02-07 |
| 1245752617 | Irfan Ahmed | Psychiatry & Neurology | 900 E. Main St., Norman, OK 73070 | 2017-07-07 |
| 1568997401 | Erin Walling | Psychiatry & Neurology | 920 Stanton L Young Blvd Ste 3440, Oklahoma City, OK 73104-5036 | 2017-04-28 |
| 1992259501 | Tranquil Psychiatry Clinic,llc | Psychiatry & Neurology | 333 Nw 5th St, Apt. No. 1010, Oklahoma City, OK 73102-3080 | 2016-08-11 |
| 1053762807 | Daniel Pappas | Psychiatry & Neurology | 15225 Fairview Farm Rd., Edmond, OK 73013 | 2016-06-23 |
| 1679937197 | Geetika M Verma Md Plcc | Psychiatry & Neurology | 5100 N Brookline Ave Bldg Suite360, Oklahoma City, OK 73112-3623 | 2016-04-11 |
| Find all providers with the same taxonomy | ||||
| City | PAULS VALLEY |
| Zip Code | 73075 |
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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.