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BEAUX GRANT KETCHUM
NPI 1578413563
Peer Specialist in Lawton, OK

Active since January 30, 2026
1320 NW HOMESTEAD DR STE G, LAWTON, OK 73505(714) 477-4605 Get Directions Write a Review

NPPES record last updated: January 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Beaux Grant Ketchum NPPES

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

BEAUX GRANT KETCHUM (NPI 1578413563) is an individual peer specialist in Lawton, Oklahoma and active in the NPI registry since January 2026.

NPPES Registry Identity

NPI1578413563
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameBEAUX GRANT KETCHUM
Location Address1320 NW HOMESTEAD DR STE GLawton, OK 73505-5243
Mailing Address1320 Nw Homestead Dr Ste GLawton, OK 73505-5243 · (714) 477-4605
Phone(714) 477-4605
Sole ProprietorNo
Enumeration DateJanuary 30, 2026
NPPES CertifiedJanuary 30, 2026
✔ NPI 1578413563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
1320 NW HOMESTEAD DR STE G, Lawton, OK 73505
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Other Providers at the Same Location NPPES 16

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

MR. KEVIN ERNEST MELLENCAMP M.S. LPC
Counselor
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (580) 355-8883
REBECCA ANN PARKER
Peer Specialist
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (323) 237-6783
PAUL ANTHONY SAENZ
Peer Specialist
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (714) 477-4605
MR. DAKOTA JAY JOHNSTONE
Peer Specialist
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (714) 477-4605
MR. CODY RYAN BLAIR BHCM 2, MA, MAT
Case Manager/Care Coordinator
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (714) 951-2257
NACONA ELIZABETH COLBERT
Peer Specialist
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (714) 477-4605
JUSTIN SNUKS OWENS
Peer Specialist
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (714) 477-4605
MRS. ELIZABETH LYDIA WILLIAMS
Peer Specialist
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505
Comanche County (714) 477-4605

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 Beaux Ketchum's NPI number?

The NPI number for Beaux Ketchum is 1578413563. It was assigned to this individual provider in the NPPES registry on January 30, 2026.

Where is Beaux Ketchum located?

Beaux Ketchum practices at 1320 NW Homestead Dr Ste G, Lawton, OK 73505. The listed phone number is (714) 477-4605.

What is Beaux Ketchum's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Beaux Ketchum was last updated on January 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.