PREMIER BEHAVORIAL HEALTH (NPI# 1295079705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295079705 |
| Entity Type | Organization |
| Organization Name | PREMIER BEHAVORIAL HEALTH |
| Practice Address |
2305 Southwest H Avenue Suite #1 Lawton OK 73501 |
| Mailing Address |
2305 South West H Avenue Suite #1 Lawton OK 73501 |
| Practice Telephone | 5806998551 |
| Practice Fax Number | 5806998553 |
| Mailing Telephone | 5806998551 |
| Mailing Fax Number | 5806998553 |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2012-11-21 |
| Authorized Official Name | DEWELL BREWER (DIRECTOR) |
| Authorized Official Telephone | 5806998551 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
2305 SOUTHWEST H AVENUE SUITE #1 |
| City | LAWTON |
| State | OK |
| Zip Code | 73501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596729 | Alyssa K Manfredi | Speech-Language Pathologist | 1700 Nw Lee Blvd, Lawton, OK 73501 | 2020-10-21 |
| 1306156989 | Diana Nix | Licensed Practical Nurse | 611 Sw B Ave, Lawton, OK 73501 | 2010-10-15 |
| 1689993214 | Crystal Leday | Physical Therapy Assistant | 602 S.e. Wallock, Lawton, OK 73501 | 2010-05-21 |
| 1457679862 | Gary Dean Gardner | Dentist | 1301 West Gore Blvd, Suite 2, Lawton, OK 73501 | 2010-05-10 |
| 1962729848 | Tayler Gammon | Hearing Instrument Specialist | 423 S.w. C Ave, Lawton, OK 73501 | 2010-04-30 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1710122833 | Provide Hearing Aids | Public Health or Welfare | 1201 West Gore Blvd, Suite D, Lawton, OK 73501 | 2008-12-03 |
| 1053506121 | Mercer Beauty Supply | Orthotic Fitter | 1016 Sw D Ave, Lawton, OK 73501 | 2007-09-11 |
| 1528273604 | Harlan L Ross Jr. | Counselor | 1719 S.w. 11th, Lawton, OK 73501 | 2007-05-11 |
| Find all providers in zip 73501 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699310276 | Creoks Mental Health Services | Community/Behavioral Health | 4704 Nw Motif Manor Blvd Ste 4, Lawton, OK 73505-4800 | 2019-11-07 |
| 1992263776 | Abundant Life Counseling Services | Community/Behavioral Health | 1105 Sw F Ave, Lawton, OK 73501-4720 | 2019-03-11 |
| 1427546514 | Internal Connections Pllc | Community/Behavioral Health | 1303 W. Gore Blve, Suite 6, Lawton, OK 73501-3666 | 2018-04-25 |
| 1720517246 | Community Strong Counseling LLC | Community/Behavioral Health | 1303 W Gore Blvd Ste 3, Lawton, OK 73501-3666 | 2017-06-08 |
| 1932569001 | Jim Taliaferro Cmhc | Community/Behavioral Health | 327 Sw C Ave, Lawton, OK 73501-4016 | 2016-03-02 |
| 1174914287 | Creative Life Counseling Services | Community/Behavioral Health | 502 North Sheridan, Suite 4, Lawton, OK 73505 | 2015-02-11 |
| 1750709903 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 1309 Sw Washington Ave, Lawton, OK 73501-7231 | 2014-04-04 |
| 1699117796 | Cordaris Onassis Butler | Community/Behavioral Health | 2800 West Gore Blvd, Lawton, OK 73505 | 2013-07-18 |
| 1619255908 | Eva Jane Fournier | Community/Behavioral Health | 1810 Nw Bell Ave, Lawton, OK 73507-6315 | 2011-08-03 |
| 1861636029 | Life Management Counseling & Consulting | Community/Behavioral Health | 621 Sw D Ave, Lawton, OK 73501-4507 | 2009-04-30 |
| Find all providers in LAWTON | ||||
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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.