# LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649796590
- **Authorized official:** DEANA THARP LPC (DEPUTY EXECUTIVE DIRECTOR)
- **Authorized official phone:** (580) 319-7305

## Contact information

- **Practice address:** 2530 S COMMERCE ST BLDG C, ARDMORE, OK 73401-5519
- **Practice address phone:** (580) 226-5048
- **Practice address fax:** (580) 226-3569
- **Mailing address:** PO BOX 189, ARDMORE, OK 73402-0189
- **Mailing address phone:** (580) 223-5070
- **Mailing address fax:** (580) 223-5617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 4157 | OK | Yes |

## Other

- **Enumeration date:** 08/22/2017
- **Last updated:** 05/20/2020