Lighthouse Counseling Center LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LIGHTHOUSE COUNSELING CENTER LLC

Doing business as

Lighthouse Counseling

Practice address

5201 SW Westgate Dr Ste 100
Portland, OR 97221-2424

Phone

(469) 297-0096

NPI assigned

Jun 8, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Earnest WallaceNPI 1730927815

Title

Ceo

Phone

(469) 297-0096

Specialties & licenses 1

Addresses

Other names 1

• Lighthouse Counseling Doing business as

Locations

Practitioners 1

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

• Earnest Wallace III, PSS

  • Peer Specialist
  • Portland, OR
  • NPI 1730927815
  NPD Authorized official

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1366136541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 SW WESTGATE DR STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212424",
            "telephone_number": "469-297-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 SW WESTGATE DR STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212424",
            "telephone_number": "469-297-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "EARNEST",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-297-0096",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lighthouse Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacob D Light, M.D.
• Lindi Jo Fawn Light, QMHA
• Michael L Lightfoot
• Katie Lighthart, AU.D.
• Emily Lighthipe, DPT
• Vicky Lightning, LMT NCTMB
• Lightshinepdx LLC
• Robert Stark Ligon III, D.C.
• Sharon Lii
• Alicia Like

• Adult Mental Health Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.