Lighthouse Behavioral Health, PLLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6301006344 Issued in MI

Legal business name

LIGHTHOUSE BEHAVIORAL HEALTH, PLLC

Practice address

811 Ship St
Suite 4B
Saint Joseph, MI 49085-1171

Phone

(269) 985-3618

Fax

(269) 609-6009

NPI assigned

Jun 9, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Patrick Hackworth, PH.D.NPI 1063448918

Title

Owner/Licensed Psychologist

Phone

(269) 985-3618

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Bruce Patrick Hackworth, PHD

  • Psychologist
  • Saint Joseph, MI
  • NPI 1063448918
  Medicare reassignment Care Compare group Authorized official
• Gale Sandra Hackworth, PHD

  • Clinical Psychologist
  • Saint Joseph, MI
  • NPI 1710519376
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1699155226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 SHIP ST",
            "address_2": "SUITE 4B",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851171",
            "telephone_number": "269-985-3618",
            "fax_number": "269-609-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SHIP ST",
            "address_2": "SUITE 4B",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851171",
            "telephone_number": "269-985-3618",
            "fax_number": "269-609-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE BEHAVIORAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "HACKWORTH",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "269-985-3618",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301006344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric P Lester, M.D.
• Samuel Edward Alpha Lewin, LLPC
• Liberty Dialysis - Lakeland LLC
• Richard Michael Liebelt, RN
• Angela Lies
• Lighthouse Concierge LLC
• Lighthouse Counseling
• Lighthouse Counseling LLP
• Holly Nicole Lignell, CMT
• Ronald Frederick Lindsay, MA. LLP

• Counseling Psychologist in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.