Organization Active NPI

Grow Well Behavioral Health LLC

Doing business as Grow Well Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tulsa, OK
National Provider Identifier
1417783903
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GROW WELL BEHAVIORAL HEALTH LLC
Doing business as
Grow Well Behavioral Health
Practice address
5840 S Memorial Dr Ste 212
Tulsa, OK 74145-9081
Phone
(918) 488-8002
NPI assigned
Sep 11, 2024
Last updated
Sep 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GROW WELL HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Matthew Clark
Title
Chief Executive Officer
Phone
(918) 488-8002

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

5840 S Memorial Dr Ste 212
Tulsa, OK 74145-9081

Mailing address

5840 S Memorial Dr Ste 212
Tulsa, OK 74145-9081
Phone (918) 644-1858

Other practice location 1

6711 S Yale Ave
Tulsa, OK 74136-3313
Phone (800) 291-8488

Other names 1

  • Grow Well Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Part of
Grow Well Health LLC

Locations

5840 S Memorial Dr
Ste 212
Tulsa, OK 74145
Phone (918) 488-8002

6711 S Yale Ave
Tulsa, OK 74136
Phone (800) 291-8488

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1417783903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 S MEMORIAL DR STE 212",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741459081",
            "telephone_number": "918-644-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 S MEMORIAL DR STE 212",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741459081",
            "telephone_number": "918-488-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6711 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741363313",
            "country_code": "US",
            "telephone_number": "800-291-8488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GROW WELL BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GROW WELL HEALTH LLC",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "918-488-8002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grow Well Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.