Island Light Psychotherapy, LLC

Key facts

NPI

1508488305

Entity type

Organization (NPI type 2)

Primary specialty

Community/Behavioral Health Agency 251S00000X

Legal business name

ISLAND LIGHT PSYCHOTHERAPY, LLC

Practice address

11 King Charles Dr Ste a
Portsmouth, RI 02871-1364

Phone

(306) 070-3153

NPI assigned

May 14, 2020

Organization subpart

No

Authorized official

Name

Emily Allerton

Title

Owner

Phone

(330) 607-0315

Practitioners 1

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

• Emily M Wygant, LMHC Mental Health Counselor · Middletown, RI · NPI 1326405556
  NPD

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 21, 2020.

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1508488305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 KING CHARLES DR STE A",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 KING CHARLES DR STE A",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711364",
            "telephone_number": "306-070-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND LIGHT PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "ALLERTON",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-607-0315"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Portsmouth, RI · Community/Behavioral Health Agency in Rhode Island