Genesis Lightbourne

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12959-C Issued in NV

Practice address

3925 Martin Luther King B
Suite 212
North Las Vegas, NV 89032

Phone

(702) 503-9544

NPI assigned

Feb 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Urban Healthy Minds, LLC

  • Community/Behavioral Health Agency
  • Henderson, NV
  • NPI 1750960043
  NPD (past)

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1649543471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 E FLAMINGO RD",
            "address_2": "#100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195249",
            "telephone_number": "702-503-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 MARTIN LUTHER KING B",
            "address_2": "SUITE 212",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-503-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTBOURNE",
        "first_name": "GENESIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "12959-C",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifetrans, Inc.
• Lifting Others Behavior Health LLC
• Jocelyn Nato Ligayo, APRN
• Carra Symone Lige
• Light House Services LLC
• Darry Lighten
• Lighthouse Behavioral Healthcare Services, LLC
• Marcus Ligon
• Sabrina Likert
• Frank Thomas Lillich II

• Clinical Social Worker in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.