Organization Active NPI

Lighthouse Professional Services Group, LLC

  • Mental Health Counselor
  • Columbus, GA
National Provider Identifier
1003496167
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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

Updated by the provider on Apr 13, 2021

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)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.