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General NPI Number Information
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NPI Number | 1477225217
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Entity Type | Organization
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Legal Business Name | BEACON BEHAVIORAL HEALTH INC
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 327 SW C AVE
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City | LAWTON
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State | OK
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Zip | 73501-4016
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Country | US
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Telephone | 580-280-1988
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Fax |
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Provider Business Mailing Address
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Address Line | 327 SW C. AVE
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City | LAWTON
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State | OK
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Zip | 73501-4016
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Country | US
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Telephone | 580-280-1988
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | WILLIAM RAY MEISER
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Credential | MS LPC
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Telephone | 580-280-1988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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