LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS
NPI 1013542190
Psychiatry & Neurology - Addiction Psychiatry in Durant, OK

Q: What is Lighthouse Behavioral Wellness Centers's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Psychiatry, with taxonomy code 2084P0802X.

Active since March 09, 2020CLIA 37D2271538 · Waiver

2425 W UNIVERSITY BLVD, DURANT, OK 74701(580) 924-7331(580) 924-7332 Get Directions Write a Review

NPPES record last updated: May 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 20, 2020, May 13, 2020, Mar 9, 2020 (3 updates tracked since 2020).

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About Lighthouse Behavioral Wellness Centers NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS (NPI 1013542190) is a healthcare organization registered as an addiction psychiatry in Durant, Oklahoma and active in the NPI registry since March 2020. The organization holds a CLIA Waiver certificate valid through November 2, 2026 and lists Deana Tharp, Deputy Executive Directcor, as its authorized official.

NPPES Registry Identity

NPI1013542190

Entity TypeOrganization

Primary Taxonomy2084P0802X

Legal Business NameLIGHTHOUSE BEHAVIORAL WELLNESS CENTERS

Location Address2425 W UNIVERSITY BLVDDurant, OK 74701-2970

Mailing Address2425 W University Blvd-ste 100Durant, OK 74701-2970

Phone(580) 924-7331

Fax(580) 924-7332

Organization SubpartNo

Authorized OfficialDeana TharpDeputy Executive Directcor · (580) 319-7305

Enumeration DateMarch 9, 2020

Last NPPES UpdateMay 20, 20203 updates tracked since enumeration

NPPES CertifiedMay 20, 2020

✔ NPI 1013542190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Addiction PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0802X

Definition

Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.

2425 W UNIVERSITY BLVD, Durant, OK 74701

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Other Identifiers 1

Medicaid100728830OK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2271538

Lighthouse Behavioral Wellness Center · Ardmore, OK

Active · expires Nov 2, 2026

CLIA Number37D2271538

Laboratory TypeCommunity Clinic

Certificate Effective DateNovember 3, 2024

Certificate Expiration DateNovember 2, 2026

Laboratory DirectorTufal Khan

Laboratory Phone(580) 319-7305

Laboratory LocationLighthouse Behavioral Wellness Center2530 S Commerce Bldg B, Ardmore, OK 73401

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COURTNEY DYANE JACKSON

Counselor (Mental Health)