1. Home
  2. Directory
  3. Oklahoma
  4. Cleveland
  5. Clinic Center
  6. NPI Profile

GRAND MENTAL HEALTH
NPI 1194365825
Clinic/Center - Mental Health (Including Community Mental Health Center) in Cleveland, OK

Active since January 10, 2020CLIA 37D2173495 · Waiver
907 W CADDO ST, CLEVELAND, OK 74020(918) 308-5511(918) 205-2701 Get Directions Write a Review

NPPES record last updated: June 13, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Grand Mental Health NPPES

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

GRAND MENTAL HEALTH (NPI 1194365825) is a healthcare organization registered as a mental health (including community mental health center) in Cleveland, Oklahoma and active in the NPI registry since January 2020. The organization holds a CLIA Waiver certificate valid through October 14, 2027 and lists Larry Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1194365825
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameGRAND LAKE MENTAL HEALTH CENTER, INC.
Location Address907 W CADDO STCleveland, OK 74020-4201
Mailing Address114 W Delaware AveNowata, OK 74048-2601 · (918) 273-1841 · Fax (918) 273-1843
Phone(918) 308-5511
Fax(918) 205-2701
Organization SubpartNo
Authorized OfficialLarry SmithCeo · (918) 273-1841
Enumeration DateJanuary 10, 2020
Last NPPES UpdateJune 13, 2022
NPPES CertifiedJune 13, 2022
✔ NPI 1194365825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
907 W CADDO ST, Cleveland, OK 74020
Open in Google Maps ↗

Other Names 1

Doing Business AsGrand Mental Health

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 37D2173495

Grand Mental Health · Cleveland, OK
Active · expires Oct 14, 2027
CLIA Number37D2173495
Laboratory TypeCcbhc
Certificate Effective DateOctober 15, 2025
Certificate Expiration DateOctober 14, 2027
Laboratory DirectorW John Mallgren
Laboratory Phone(918) 418-0994
Laboratory LocationGrand Mental Health907 W Caddo St, Cleveland, OK 74020
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

MALCOLM JOHN WHITE
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 273-1841
RITA CARMEN RODRIGUEZ
Peer Specialist
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 273-1841
DANIEL ANTWAIN SHAW MAE
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 308-5511
ADRIAN DEAN EDDINGS
Peer Specialist
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 308-5511
CARRIE RENE HOLLOWAY
Community/Behavioral Health
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (844) 458-2100
MRS. AMY COMPTON
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 358-5339
MR. JAMES CORY GARNER
Counselor (Mental Health)
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 308-5511
KELLY MCDONALD
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 308-5511

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Lake Mental Health Center, Inc.'s NPI number?

The NPI number for Grand Lake Mental Health Center, Inc. is 1194365825. It was assigned to this organization in the NPPES registry on January 10, 2020. The provider is doing business as Grand Mental Health.

Where is Grand Lake Mental Health Center, Inc. located?

Grand Lake Mental Health Center, Inc. is located at 907 W Caddo St, Cleveland, OK 74020. The listed phone number is (918) 308-5511.

What is Grand Lake Mental Health Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Grand Lake Mental Health Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2173495) is associated with this NPI, valid through October 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grand Lake Mental Health Center, Inc. was last updated on June 13, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.