GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1235534355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235534355 |
| Entity Type | Organization |
| Organization Name | GRAND LAKE MENTAL HEALTH CENTER, INC. |
| Other Organization Name | GRAND LAKE MEDICAL HEALTH CENTER |
| Practice Address |
700 Sw Penn Ave Bartlesville OK 74003-3847 |
| Mailing Address |
114 W Delaware Ave Nowata OK 74048-2601 |
| Practice Telephone | 9182731841 |
| Mailing Telephone | 9182731841 |
| Enumeration Date | 2014-10-31 |
| 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 |
700 SW PENN AVE |
| City | BARTLESVILLE |
| State | OK |
| Zip Code | 74003-3847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851631469 | Angela Evans | Social Worker | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2013-02-19 |
| 1386284222 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2020-01-08 |
| 1356832034 | Cheyenne Salome Hill | Case Manager/Care Coordinator | 700 Sw Penn Ave, Bartlesville, OK 74003 | 2018-05-29 |
| 1083110068 | Barbara Curtsinger | Peer Specialist | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2018-03-30 |
| 1437665775 | Jordan Elizabeth Roane | Case Manager/Care Coordinator | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2017-12-22 |
| 1902322985 | Dawn Marie Offutt | Peer Specialist | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2017-08-21 |
| 1740705581 | Traci L Watson | Case Manager/Care Coordinator | 700 Sw Penn Ave, Bartlesville, OK 74003-3847 | 2017-08-12 |
| 1205372372 | Brandon Heath Lalli | Case Manager/Care Coordinator | 700 Sw Penn Ave, Grand Lake Mental Health Center, Inc, Bartlesville, OK 74003-3847 | 2017-01-13 |
| 1104168145 | Rena Taliaferro | Counselor | 700 Sw Penn Ave, Bartlesville, OK 74003 | 2013-03-16 |
| 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 |
| 1902813033 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2006-08-02 |
| 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 |
| 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.