NPIMap

Organization Active NPI

Lighthouse Associates LLC

  • Clinical Social Worker
  • Ludington, MI
National Provider Identifier
1053759589
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LB064630 Issued in MI
Legal business name
LIGHTHOUSE ASSOCIATES LLC
Practice address
5705 W Johnson Rd
Ludington, MI 49431-1516
Phone
(231) 425-4414
Fax
(231) 425-4434
NPI assigned
Jun 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa A Bradley, ACSWNPI 1154310720
Title
President
Phone
(231) 425-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LB064630 MI Primary

Addresses

Primary practice location

5705 W Johnson Rd
Ludington, MI 49431-1516

Mailing address

5705 W Johnson Rd
Ludington, MI 49431-1516
Phone (231) 425-4414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130905000101 MI Part B Supplier - Clinic/Group Practice 0547403867 Receives reassigned benefits from 7 practitioners
Practice locations: Ludington, MI

National Provider Directory

National Provider Directory

Locations

409 W Ludington Ave
Ste 30
Ludington, MI 49431
Phone (231) 425-4414

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1053759589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 W JOHNSON RD",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311516",
            "telephone_number": "231-425-4414",
            "fax_number": "231-425-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 W JOHNSON RD",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311516",
            "telephone_number": "231-425-4414",
            "fax_number": "231-425-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-425-4414",
        "authorized_official_credential": "ACSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "LB064630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.