LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS (NPI# 1740672880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740672880 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS |
| Practice Address |
2425 W University Blvd Ste 100 Durant OK 74701-2970 |
| Practice Telephone | 5809247331 |
| Practice Fax Number | 5809247332 |
| Mailing Telephone | 5809247330 |
| Mailing Fax Number | 5809242739 |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | MRS. DEANA MICHELLE 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 | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100728830A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
2425 W UNIVERSITY BLVD STE 100 |
| City | DURANT |
| State | OK |
| Zip Code | 74701-2970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790005 | Timothy Thannisch | Registered Nurse | 2425 W University Blvd Ste 100, Durant, OK 74701-2970 | 2020-11-04 |
| 1033731971 | Crystal Wrape | Case Manager/Care Coordinator | 2425 W University Blvd Ste 100, Durant, OK 74701-2970 | 2020-05-14 |
| 1770104267 | Michael Gorsch | Case Manager/Care Coordinator | 2425 W University Blvd Ste 100, Durant, OK 74701-2970 | 2020-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851781975 | Urgent Care Walk In Clinic LLC | Clinic/Center | 702 Bryan Dr, Suite 200, Durant, OK 74701-7030 | 2015-01-27 |
| 1609295898 | Durant Hma Physician Management LLC | Clinic/Center | 1807 W University Blvd, Durant, OK 74701-3011 | 2014-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902426737 | Creekside Urgent Care LLC | Clinic/Center | 1101 Nw 178th St Ste B, Edmond, OK 73012-4281 | 2020-04-22 |
| 1629604434 | Medwise LLC | Clinic/Center | 11495 S. State Highway 51, Coweta, OK 74429 | 2020-03-13 |
| 1831722982 | Sooner Urgent Care LLC | Clinic/Center | 2100 W Lindsey St Ste B, Norman, OK 73069-4108 | 2020-02-18 |
| 1720639263 | Nicholette Brosseau | Clinic/Center | 1520 Sw 1st St, Wagoner, OK 74467-4839 | 2019-09-25 |
| 1548819477 | Christi Lea Vick | Clinic/Center | 704 Azalea Hill Dr, Yukon, OK 73099-6504 | 2019-09-04 |
| 1447805544 | Revive Medical Urgent Care LLC | Clinic/Center | 4215 N Classen Blvd Ste 100, Oklahoma City, OK 73118-2426 | 2019-08-06 |
| 1780239202 | Immediate Care of Oklahoma, LLC | Clinic/Center | 10616 U.S. Highway 66, Suite 100, Oklahoma City, OK 73099 | 2019-08-02 |
| 1982161386 | On Demand Urgent Care, LLC | Clinic/Center | 11426 N 134th E Ave, Owasso, OK 74055-5755 | 2019-02-22 |
| 1720554231 | Gdn LLC | Clinic/Center | 1315 Chisholm Trail Pkwy, Duncan, OK 73533-1533 | 2018-10-23 |
| 1699262576 | Immediate Care of Oklahoma, LLC | Clinic/Center | 4500 Tinker Rd, Oklahoma City, OK 73135-4614 | 2018-04-17 |
| 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.