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Contact Information

LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS
2425 W UNIVERSITY BLVD
DURANT, OK74701-2970
 Phone: 580-924-7331
 Fax: 580-924-7332
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS · (Female)

NPI Number 1013542190
Status Active
Credentials
Entity Individual
Enumeration date 03/09/2020
Last updated 05/20/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK Medicaid 100728830
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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