Organization
LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANA THARP LPC (CHIEF CLINICAL COMPLIANCE OFFICER)
(580) 319-7305
Entity
Organization
Contact information
Practice address
9 10TH AVE NW, ARDMORE, OK 73401-5929
(580) 226-1656
(844) 270-7511
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
(580) 319-7305
(580) 319-7328
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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