| Behavioral Health Inc. | |
|
5512 S Lewis Ave Tulsa OK 74105-7140 | |
| (918) 747-1600 | |
| (918) 749-2774 |
| Full Name | Behavioral Health Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5512 S Lewis Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Larry David Vaught (OWNER) |
| Authorized Official Contact | 9187471600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Inc. 5512 S Lewis Ave Tulsa OK 74105-7140 Ph: (918) 747-1600 | Behavioral Health Inc. 5512 S Lewis Ave Tulsa OK 74105-7140 Ph: (918) 747-1600 |
| NPI Number | 1891911905 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 07/05/2010 |
| Medicare PECOS PAC ID | 3577724871 |
|---|---|
| Medicare Enrollment ID | O20120413000040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891911905 | NPI | - | NPPES |
| 100838930C | Medicaid | OK | |
| 100838930A | Medicaid | OK | |
| 440486035001 | Other | OK | BCBS |
| 5175055 | Other | OK | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 441 (Oklahoma) | Primary |
| Provider Name | Larry D Vaught |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629141775 PECOS PAC ID: 1052581832 Enrollment ID: I20120413000067 |
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