Radiant Light Behavioral Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RADIANT LIGHT BEHAVIORAL SERVICES LLC

Practice address

625 E 2ND Ave
Gastonia, NC 28054-0470

Phone

(704) 222-2348

NPI assigned

Jun 14, 2021

Last updated

Jun 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Davis

Title

Credentialing Specialists

Phone

(912) 373-4385

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1518535806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18361",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282180361",
            "telephone_number": "704-222-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540470",
            "telephone_number": "704-222-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT LIGHT BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALISTS",
        "authorized_official_telephone_number": "912-373-4385"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R & S Willis, Inc
• R&Syouthhavenllc
• Beenal Rachh, PT
• David Bernie Radford, RPH
• Radiant Light Behavioral Concepts, LLC
• Nequita Latasha Denora Ragas, FNP-C
• Ashvin T Ragoowansi, M.D.
• Sarah Evans Blanchard Rahman, OT
• Carly Marie Raimondo, MA, LMFTA
• Lazelma Anita Rainey

• Community/Behavioral Health Agency in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.