NPIMap

Organization Active NPI

Behavioral Health Inc.

  • Psychologist
  • Tulsa, OK
National Provider Identifier
1891911905
Registry record updated Jul 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
441 Issued in OK
Legal business name
BEHAVIORAL HEALTH INC.
Practice address
5512 S Lewis Ave
Tulsa, OK 74105-7140
Phone
(918) 747-1600
Fax
(918) 749-2774
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2010

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

Authorized official

Name
Dr. Larry David Vaught, PH.D.NPI 1629141775
Title
Owner
Phone
(918) 747-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 441 OK Primary

Addresses

Primary practice location

5512 S Lewis Ave
Tulsa, OK 74105-7140

Mailing address

5512 S Lewis Ave
Tulsa, OK 74105-7140
Phone (918) 747-1600

Other identifiers 4

IdentifierTypeStateIssuer
100838930CMedicaidOK
100838930AMedicaidOK
440486035001OtherOKBCBS
5175055OtherOKAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120413000040 OK Part B Supplier - Clinic/Group Practice 3577724871 Receives reassigned benefits from 1 practitioner
Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory

Locations

5512 S Lewis Ave
Tulsa, OK 74105
Phone (918) 510-4554

Practitioners & affiliated clinicians

Practitioners 10

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278288000000",
    "number": "1891911905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057140",
            "telephone_number": "918-747-1600",
            "fax_number": "918-749-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057140",
            "telephone_number": "918-747-1600",
            "fax_number": "918-749-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2010-07-05",
        "status": "A",
        "authorized_official_last_name": "VAUGHT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-747-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "OK",
            "license": "441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100838930C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100838930A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "440486035001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5175055",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.