Mara's Lighthouse Counseling Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MARA'S LIGHTHOUSE COUNSELING CENTER, LLC

Practice address

12086 Fort Caroline Rd Ste 201
Jacksonville, FL 32225-2689

Phone

(904) 990-8105

Fax

(904) 562-3359

NPI assigned

May 11, 2020

Organization subpart

No

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

Authorized official

Name

Alex De Guzman

Title

Office Manager

Phone

(904) 990-8105

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Maras Lighthouse Counseling Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mara's Lighthouse Counseling Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, FL
  • NPI 1962974766
  NPD tax ID

Locations

Practitioners 9

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

• Shamara Gibson, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1598140733
  Medicare reassignment Care Compare group NPD
• Ashley Marie Martin, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1164196259
  Medicare reassignment Care Compare group NPD
• Tamara McKenzie

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1558807701
  Medicare reassignment Care Compare group NPD
• Tameka Denise Terry, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1114685161
  Medicare reassignment Care Compare group NPD
• Magenta Hall, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tallahassee, FL
  • NPI 1518465582
  Medicare reassignment NPD
• Bernadette Taggart

  • Clinical Social Worker
  • New Port Richey, FL
  • NPI 1902629512
  Medicare reassignment NPD
• Diamond Tiara Williams, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1518545797
  Medicare reassignment NPD
• Bria Odom

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1992389639
  Medicare reassignment
• Rozlynn B Horton

  • Clinical Social Worker
  • Tallahassee, FL
  • NPI 1821741364
  NPD (past)

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1407478613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12086 FORT CAROLINE RD STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252689",
            "telephone_number": "904-990-8105",
            "fax_number": "904-562-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12086 FORT CAROLINE RD STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252689",
            "telephone_number": "904-990-8105",
            "fax_number": "904-562-3359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Kingsley Ave Ste 212214",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735685",
            "country_code": "US",
            "telephone_number": "904-990-8105",
            "fax_number": "904-562-3359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARA'S LIGHTHOUSE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-990-8105"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maples, Neal and Winter (Advanced Dental Services of Jacksonville)
• Rebecca Lynn Maples, PAS2
• Stacy Maples
• William James Maples, M.D.
• Mara Health Centers LLC
• Mara's Lighthouse Counseling Center, LLC
• Todd Marabanian, PA-C
• Paul P Maraj, M.D.
• Nang Aung Maran, MSN, APRN, AGACNP-BC
• Nizar Fuad Maraqa, MD

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.