Lighthouse Behavior Center, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LIGHTHOUSE BEHAVIOR CENTER, LLC

Practice address

27 SE 24TH Ave
Pompano Beach, FL 33062-5346

Phone

(281) 881-7983

NPI assigned

Jul 15, 2021

Organization subpart

No

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

Authorized official

Name

Angela L Tallo, LMHCNPI 1932456894

Title

Co-Ceo Co-Founder

Phone

(281) 881-7983

Specialties & licenses 1

Addresses

Other names 1

• Lighthouse Wellness Center Other name

Locations

Practitioners 1

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

• Angela Lorin Tallo, M. ED, NCC, LPCS

  • Professional Counselor
  • Houston, TX
  • NPI 1932456894
  NPD Authorized official

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1093387250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SE 24TH AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330625346",
            "telephone_number": "281-881-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SE 24TH AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330625346",
            "telephone_number": "281-881-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE BEHAVIOR CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "TALLO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CO-CEO CO-FOUNDER",
        "authorized_official_telephone_number": "281-881-7983",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Lighthouse Healthcare Management North LLC
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• Lighthouse Medical Center, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.