National Provider Identifier Database

LIGHTHOUSE SUPPORT SERVICES LLC
Clinical

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.


Contact Information

LIGHTHOUSE SUPPORT SERVICES LLC
7516 E MAIN ST STE 1
MESA, AZ85207-8332
Phone: 602-526-0302
Fax:
Website:
Specialty Taxonomy Code
* Clinical 103TC0700X
Adult Mental Health 261QM0850X
Clinical Medical Laboratory 291U00000X
Community/Behavioral Health 251S00000X
Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for LIGHTHOUSE SUPPORT SERVICES LLC

NPI Number 1033817333
Legal business name
LBN
LIGHTHOUSE SUPPORT SERVICES LLC
Authorized official JESSICA EVANS - (ADMIN)
Entity Organization
Organization subpart No
Enumeration date 02/16/2023
Last updated 03/15/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: 123007

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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