LIGHTHOUSE SUPPORT SERVICES LLC NPI 1033817333

NPI Information

  • NPI: 1033817333
  • Provider Name: LIGHTHOUSE SUPPORT SERVICES LLC
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 7516 E MAIN ST STE 1
    MESA, AZ
    ZIP 85207
  • Phone: (602) 526-0302

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NPI Details

LIGHTHOUSE SUPPORT SERVICES LLC is a clinical psychologist in Mesa, AZ. The provider is 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. LIGHTHOUSE SUPPORT SERVICES LLC NPI is 1033817333. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7516 E MAIN ST STE 1
MESA, AZ
ZIP 85207-332
Phone: (602) 526-0302

The provider's authorized official is Jessica Evans .
The authorized official title is Admin and has the following contact phone number (602) 526-0302.

The enumeration date for this NPI number is 2/16/2023 and was last updated on 3/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalYes
2251S00000XCommunity/Behavioral HealthNo
3261QM0850XClinic/CenterAdult Mental HealthNo
4291U00000XClinical Medical LaboratoryNo
5324500000XSubstance Abuse Rehabilitation FacilityNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1123007MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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