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GRAND LAKE MENTAL HEALTH CENTER, INC.
NPI 1568042380
Clinic/Center - Mental Health (Including Community Mental Health Center) in Ponca City, OK

Active since April 14, 2021
2225 N UNION ST., PONCA CITY, OK 74601(918) 308-5515(580) 215-5765 Get Directions Write a Review

NPPES record last updated: April 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Grand Lake Mental Health Center, Inc. NPPES

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

GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI 1568042380), doing business as Grand Lake Medical Heatlh Center, is a healthcare organization registered as a mental health (including community mental health center) in Ponca City, Oklahoma and active in the NPI registry since April 2021. The organization lists Larry Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1568042380
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameGRAND LAKE MENTAL HEALTH CENTER, INC.
Location Address2225 N UNION ST.Ponca City, OK 74601-1536
Mailing Address114 W Delaware AveNowata, OK 74048-2601 · (918) 273-1841 · Fax (918) 273-1843
Phone(918) 308-5515
Fax(580) 215-5765
Organization SubpartNo
Authorized OfficialLarry SmithCeo · (918) 273-1841
Enumeration DateApril 14, 2021
NPPES CertifiedMarch 23, 2021
✔ NPI 1568042380 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
2225 N UNION ST., Ponca City, OK 74601
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Other Names 1

Doing Business AsGrand Lake Medical Heatlh Center

Other Providers at the Same Location NPPES 7

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

JENNIFER D TURNEY LMSW, MSW U/S
Social Worker
2225 N UNION ST.
PONCA CITY, OK 74601
Kay County (918) 308-5515
KAELLA R KELLEY
Peer Specialist
2225 N UNION ST.
PONCA CITY, OK 74601
Kay County (580) 308-5515
NICOLE ROBERTS
Case Manager/Care Coordinator
2225 N UNION ST.
PONCA CITY, OK 74601
Kay County (580) 308-5515
LEE HALVOR SIMPSON PA-C
Physician Assistant
2225 N UNION ST.
PONCA CITY, OK 74601
Kay County (918) 308-5515
MRS. TAMRA LYNN CUNNINGHAM
Peer Specialist
2225 N UNION ST.
PONCA CITY, OK 74601
Kay County (580) 308-5515
TAYLOR J DIVELEY
Case Manager/Care Coordinator
2225 N UNION ST.
PONCA CITY, OK 74601
Kay County (580) 308-5515
SHELLI MAGIN LPC
Counselor (Mental Health)
2225 N UNION ST.
PONCA CITY, OK 74601
Kay County (918) 308-5515

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 1568042380. It was assigned to this organization in the NPPES registry on April 14, 2021. The provider is doing business as Grand Lake Medical Heatlh Center.

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

Grand Lake Mental Health Center, Inc. is located at 2225 N Union St., Ponca City, OK 74601. The listed phone number is (918) 308-5515.

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.

When was this NPI record last updated?

The NPPES record for Grand Lake Mental Health Center, Inc. was last updated on April 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.