NPIMap

Organization Active NPI

Lighthouse Professional Clinic, P.C.

  • Psychiatry Physician
  • Ludington, MI
National Provider Identifier
1407902109
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LIGHTHOUSE PROFESSIONAL CLINIC, P.C.
Practice address
409 W Ludington Ave Ste 307
Ludington, MI 49431-2377
Phone
(231) 843-8877
Fax
(231) 845-0264
NPI assigned
Jan 26, 2007
Last updated
Jun 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Stanley L Seuferer, D.O.
Title
Owner
Phone
(231) 843-8877

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X MI
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X MI Primary

Addresses

Primary practice location

409 W Ludington Ave Ste 307
Ludington, MI 49431-2377

Mailing address

409 W Ludington Ave Ste 307
Ludington, MI 49431-2377
Phone (231) 843-8877

National Provider Directory

National Provider Directory

Locations

202 N Park St
Ludington, MI 49431
Phone (231) 843-8877

409 W Ludington Ave
Ludington, MI 49431
Phone (231) 843-4117

409 W Ludington Ave
Ste 307
Ludington, MI 49431
Phone (231) 843-8766

Practitioners & affiliated clinicians

Practitioners 7

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1407902109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W LUDINGTON AVE STE 307",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312377",
            "telephone_number": "231-843-8877",
            "fax_number": "231-845-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W LUDINGTON AVE STE 307",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312377",
            "telephone_number": "231-843-8877",
            "fax_number": "231-845-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PROFESSIONAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "SEUFERER",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-843-8877",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": null,
            "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 Jun 5, 2008; 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.