NPIMap

Organization Active NPI

Halcyon Management Group, Inc.

Doing business as Lighthouse Addiction Services

  • Addiction (Substance Use Disorder) Counselor
  • Port Charlotte, FL
National Provider Identifier
1164822193
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2008AD655206 Issued in FL
Legal business name
HALCYON MANAGEMENT GROUP, INC.
Doing business as
Lighthouse Addiction Services
Practice address
3596 Tamiami TRL Ste 205
Port Charlotte, FL 33952-8252
Phone
(941) 255-5900
Fax
(941) 764-8285
NPI assigned
Aug 27, 2014
Last updated
Aug 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Authorized official

Name
Mr. Barry K Wyrick
Title
Chief Operating Officer
Phone
(941) 255-5900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2008AD655206 FL Primary
Mental Health Counselor 101YM0800X NU

Addresses

Primary practice location

3596 Tamiami TRL Ste 205
Port Charlotte, FL 33952-8252

Mailing address

3596 Tamiami TRL Ste 205
Port Charlotte, FL 33952-8252
Phone (941) 255-5900

Other names 1

  • Lighthouse Addiction Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1164822193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3596 TAMIAMI TRL STE 205",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528252",
            "telephone_number": "941-255-5900",
            "fax_number": "941-764-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3596 TAMIAMI TRL STE 205",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528252",
            "telephone_number": "941-255-5900",
            "fax_number": "941-764-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALCYON MANAGEMENT GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "WYRICK",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "941-255-5900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "2008AD655206",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Addiction Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.