Lighthouse Mental Health Family Therapy Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIGHTHOUSE MENTAL HEALTH FAMILY THERAPY SERVICES

Practice address

190 S Orchard Ave Ste A110
Vacaville, CA 95688-3649

Phone

(707) 689-5553

Fax

(707) 660-8206

NPI assigned

Aug 20, 2024

Organization subpart

No

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

Authorized official

Name

Loletta M Holloway, LMFTNPI 1336611458

Title

Owner

Phone

(707) 689-5553

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Loletta M Holloway, LMFT

  • Mental Health Counselor
  • Vacaville, CA
  • NPI 1336611458
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1669205357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1787",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956961787",
            "telephone_number": "707-689-5553",
            "fax_number": "707-660-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S ORCHARD AVE STE A110",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956883649",
            "telephone_number": "707-689-5553",
            "fax_number": "707-660-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE MENTAL HEALTH FAMILY THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "LOLETTA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-689-5553",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.