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Organization

LIGHTHOUSE PSYCHOLOGICAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CALEY GREGG PHD (LICENSED HEALTH SERVICE PSYCHOLOGIS)
(405) 641-5367
Entity
Organization

Contact information

Practice address
510 24TH AVE SW, NORMAN, OK 73069-5106
(405) 329-7923
(405) 329-8815
Mailing address
510 24TH AVE SW, NORMAN, OK 73069-5106
(405) 329-7923
(405) 329-8815

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
5124
OK
103T00000X
Psychologist
Primary
1237
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1073891594
INDIVIDUAL NPI
OK
05
1073891594
OK
01
1235499773
INDIVIDUAL NPI
OK
05
1235499773
OK
05
1639545965
OK
05
200447140 A
OK
05
200599660 A
OK
05
200602650 A
OK
05
200602650 B
OK
Enumeration date
08/20/2015
Last updated
09/08/2015
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