Active NPI
Lighthouse Professional Services Group, LLC
- Mental Health Counselor
- Columbus, GA
National Provider Identifier
1003496167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- LIGHTHOUSE PROFESSIONAL SERVICES GROUP, LLC
- Practice address
- 2102 7TH St
Columbus, GA 31906-3606 - Phone
- (706) 392-5008
- NPI assigned
- Apr 13, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sharmekia Lashon Fortson-Hollis, LPC
- Title
- Founder/Ceo/LPC
- Phone
- (706) 392-5008
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2102 7TH St
Columbus, GA 31906-3606
Mailing address
54 Ryan Loop
Phenix City, AL 36869-7412
Phone (706) 392-5008
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Columbus, GA
- NPI 1891206660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618272000000",
"number": "1003496167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 RYAN LOOP",
"city": "PHENIX CITY",
"state": "AL",
"postal_code": "368697412",
"telephone_number": "706-392-5008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 7TH ST",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319063606",
"telephone_number": "706-392-5008"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIGHTHOUSE PROFESSIONAL SERVICES GROUP, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-13",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A",
"authorized_official_last_name": "FORTSON-HOLLIS",
"authorized_official_first_name": "SHARMEKIA",
"authorized_official_middle_name": "LASHON",
"authorized_official_title_or_position": "FOUNDER/CEO/LPC",
"authorized_official_telephone_number": "706-392-5008",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.