GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1902813033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902813033 |
| Entity Type | Organization |
| Organization Name | GRAND LAKE MENTAL HEALTH CENTER, INC. |
| Other Organization Name | GRAND LAKE MENTAL HEALTH CENTER, INC.-WASHINGTON COUNTY |
| Practice Address |
700 S Penn Ave Bartlesville OK 74003-3847 |
| Mailing Address |
114 W Delaware Ave Nowata OK 74048-2601 |
| Practice Telephone | 9183378080 |
| Practice Fax Number | 9183378099 |
| Mailing Telephone | 9183378080 |
| Mailing Fax Number | 9183378099 |
| Enumeration Date | 2006-08-02 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100732860I | 05 |
| Other Name | Type Code |
|---|---|
| Grand Lake Medical Health Center | Doing Business As Name - Organization |
| Grand Lake Mental Health Center, Inc.-Washington County | Other Name - Individual/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 |
700 S PENN AVE |
| City | BARTLESVILLE |
| State | OK |
| Zip Code | 74003-3847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877325 | Shelby Elizabeth Brennan | Peer Specialist | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-10-05 |
| 1134747827 | Brian Weaver Mclanahan | Social Worker | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-07-08 |
| 1144857442 | Elizabeth Baughman Anderson | Case Manager/Care Coordinator | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-03-25 |
| 1477187870 | Zachary James Frische | Counselor | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-02-25 |
| 1538799705 | Brytani Janiskee | Case Manager/Care Coordinator | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-01-16 |
| 1659911469 | Khyrstee Daven Norman | Peer Specialist | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-01-09 |
| 1912547894 | Lori Marie Rose | Case Manager/Care Coordinator | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-01-08 |
| 1184263535 | Emilee Brooke Mcdonald | Case Manager/Care Coordinator | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2020-01-02 |
| 1821637885 | Jessica Marie Bullen | Case Manager/Care Coordinator | 700 S Penn Ave, Bartlesville, OK 74003 | 2019-12-22 |
| 1306484407 | Ciarra Powell | Peer Specialist | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2019-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637366 | Crystal Dawn Adams | Peer Specialist | 200 N Sante Fe Ave, Bartlesville, OK 74003 | 2020-10-20 |
| 1780226506 | Heather Leigh Shoesmith | Speech-Language Pathologist | 117 West 5th Street, Bartlesville, OK 74003 | 2019-10-14 |
| 1356995815 | Monica Elizabeth Mccleary | Case Manager/Care Coordinator | 1804 S Dewey Ave, Bartlesville, OK 74003 | 2019-08-01 |
| 1396209359 | Newview Oklahoma Inc. | Occupational Therapy Assistant | 102 Sw Frank Phillips Blvd, Bartlesville, OK 74003 | 2019-01-24 |
| 1952762403 | Lee Ann Bond | Case Manager/Care Coordinator | 700 S.w. Penn Ave, Bartlesville, OK 74003 | 2016-03-11 |
| 1194102897 | Tiffany Jones | Case Manager/Care Coordinator | 1679 S Oal Ave, Bartlesville, OK 74003 | 2015-05-01 |
| 1073913125 | Kaileigh Jo Johnson | Behavioral Analyst | 700 S. Pen Ave, Bartlesville, OK 74003 | 2014-08-26 |
| 1699190595 | Mindy Karyl Mccoy | Occupational Therapist | 7256 Cr 2145, Bartlesville, OK 74003 | 2014-02-28 |
| 1841612025 | Kori A Sauer | Nurse Practitioner | 501 E. Frank Phillips Blvd., Suite 202, Bartlesville, OK 74003 | 2014-01-07 |
| 1265876122 | Teri G Woodward | Community Health Worker | 325 S Osage, Bartlesville, OK 74003 | 2013-04-23 |
| Find all providers in zip 74003 | ||||
| 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 |
|---|---|---|---|---|
| 1700326816 | Preferred Family Healthcare, Inc. | Clinic/Center | 2114 Se Washington Blvd, Bartlesville, OK 74006-7254 | 2017-03-08 |
| 1003292061 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 | 2015-07-31 |
| 1033759972 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 | 2020-01-08 |
| 1386284222 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2020-01-08 |
| 1235534355 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2014-10-31 |
| 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 | ||||
| City | BARTLESVILLE |
| Zip Code | 74003 |
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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.