Grand Lake Therapeutics LLC
NPI 1528670239 · Professional Counselor · Grove, OK
Grand Lake Therapeutics LLC is a Professional Counselor organization in Grove, OK (NPI 1528670239).
Provider details
- NPI number
- 1528670239
- Entity type
- Organization
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Mitzy Kantor, Owner(918) 786-0875
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-08-24
- Last updated
- 2020-08-24
- Certified
- 2020-08-24
Frequently asked questions
- What is Grand Lake Therapeutics LLC's NPI number?
- Grand Lake Therapeutics LLC's National Provider Identifier (NPI) is 1528670239, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grand Lake Therapeutics LLC?
- Grand Lake Therapeutics LLC is classified in the NPPES registry as Professional Counselor (Behavioral Health & Social Service Providers).
- Where is Grand Lake Therapeutics LLC located?
- Grand Lake Therapeutics LLC's practice location on file with NPPES is 1441 Lakeside Dr, Grove, OK 74344-4223.
- What is Grand Lake Therapeutics LLC's phone number?
- The practice phone number listed in the NPPES registry for Grand Lake Therapeutics LLC is (918) 786-0875.
- Who is the authorized official for Grand Lake Therapeutics LLC?
- The authorized official listed on Grand Lake Therapeutics LLC's NPPES record is Mitzy Kantor, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grand Lake Therapeutics LLC's NPI active?
- Yes — Grand Lake Therapeutics LLC's NPI (1528670239) is active in the NPPES registry as of the last update on 2020-08-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.