NPIMap

Organization Active NPI

Lighthouse Psychological Clinic, PLLC

  • Mental Health Counselor
  • Shelby TWP, MI
National Provider Identifier
1700501087
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIGHTHOUSE PSYCHOLOGICAL CLINIC, PLLC
Practice address
52188 Van Dyke Ave Ste 300
Shelby TWP, MI 48316-3575
Phone
(586) 244-8211
NPI assigned
Oct 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Authorized official

Name
Jonathan Hart, LPCNPI 1821453663
Title
President
Phone
(586) 244-8211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

52188 Van Dyke Ave Ste 300
Shelby TWP, MI 48316-3575

Mailing address

52188 Van Dyke Ave Ste 300
Shelby TWP, MI 48316-3575
Phone (586) 244-8211

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1700501087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52188 VAN DYKE AVE STE 300",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483163575",
            "telephone_number": "586-244-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52188 VAN DYKE AVE STE 300",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483163575",
            "telephone_number": "586-244-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PSYCHOLOGICAL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-08",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-244-8211",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.