| Lighthouse Behavioral Wellness Centers | |
|
109 S Willow St Pauls Valley OK 73075-3833 | |
| (405) 238-7311 | |
| (405) 238-3530 |
| Full Name | Lighthouse Behavioral Wellness Centers |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 109 S Willow St, Pauls Valley, Oklahoma |
| Authorized Official Name and Position | Deana Tharp (DEPUTY EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5803197305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Behavioral Wellness Centers Po Box 189 Ardmore OK 73402-0189 Ph: (580) 223-5070 | Lighthouse Behavioral Wellness Centers 109 S Willow St Pauls Valley OK 73075-3833 Ph: (405) 238-7311 |
| NPI Number | 1720404932 |
|---|---|
| Provider Enumeration Date | 03/12/2014 |
| Last Update Date | 05/20/2020 |
| Certification Date | 05/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720404932 | NPI | - | NPPES |
| 100728830 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 100728830 (Oklahoma) | Primary |
Excel Mhs, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 513 S Willow St, Pauls Valley, OK 73075 Phone: 405-926-2085 Fax: 405-926-2089 | |
North Care Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 W Paul Ave, Pauls Valley, OK 73075 Phone: 405-858-2700 Fax: 405-858-2720 | |
Lighthouse Behavioral Wellness Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 S Willow St, Pauls Valley, OK 73075 Phone: 580-223-5070 Fax: 580-223-5617 |