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GRAND MENTAL HEALTH
NPI 1336788652
Clinic/Center - Mental Health (Including Community Mental Health Center) in Pryor, OK

Active since January 03, 2020CLIA 37D2086301 · Waiver
109 N FAIRLAND ST, PRYOR, OK 74361(918) 825-1405(918) 825-1406 Get Directions Write a Review

NPPES record last updated: June 13, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Grand Mental Health NPPES

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

GRAND MENTAL HEALTH (NPI 1336788652) is a healthcare organization registered as a mental health (including community mental health center) in Pryor, Oklahoma and active in the NPI registry since January 2020. The organization holds a CLIA Waiver certificate valid through October 30, 2026 and lists Larry Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1336788652
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameGRAND LAKE MENTAL HEALTH CENTER, INC.
Location Address109 N FAIRLAND STPryor, OK 74361-4203
Mailing Address114 W Delaware AveNowata, OK 74048-2601 · (918) 273-1841 · Fax (918) 273-1843
Phone(918) 825-1405
Fax(918) 825-1406
Organization SubpartNo
Authorized OfficialLarry SmithCeo · (918) 273-1841
Enumeration DateJanuary 3, 2020
Last NPPES UpdateJune 13, 2022
NPPES CertifiedJune 13, 2022
✔ NPI 1336788652 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
109 N FAIRLAND ST, Pryor, OK 74361
Open in Google Maps ↗

Other Names 1

Doing Business AsGrand Mental Health

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 37D2086301

Grand Mental Health · Pryor, OK
Active · expires Oct 30, 2026
CLIA Number37D2086301
Laboratory TypeCcbhc
Certificate Effective DateOctober 31, 2024
Certificate Expiration DateOctober 30, 2026
Laboratory DirectorJohn W. Mallgren
Laboratory Phone(918) 418-0994
Laboratory LocationGrand Mental Health109 N Fairland St, Pryor, OK 74361
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.

KALI ROSE KERNS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
JACKIE ELAINE HORTON
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
WHITNEY JOANNA PHILLIPS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
BREANNA NICOLE COOK MHR, LPC-C
Counselor (Mental Health)
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1401
NICOLE BURNHAM LPN
Licensed Practical Nurse
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
STEPHANIE RENEE STACY
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841
CRYSTAL MICHELLE CUMMINS
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
KANDICE BRIANS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841

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 1336788652. It was assigned to this organization in the NPPES registry on January 3, 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 109 N Fairland St, Pryor, OK 74361. The listed phone number is (918) 825-1405.

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 37D2086301) is associated with this NPI, valid through October 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grand Lake Mental Health Center, Inc. accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Grand Lake Mental Health Center, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.