NPIMap

Organization Active NPI

Lighthouse Psychiatry & Behavioral Health Clinic LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Madison, AL
National Provider Identifier
1730855768
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LIGHTHOUSE PSYCHIATRY & BEHAVIORAL HEALTH CLINIC LLC
Practice address
8215 Madison Blvd Ste 130
Madison, AL 35758-2000
Phone
(256) 325-2500
NPI assigned
Aug 19, 2021
Last updated
Jan 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Katy CousartNPI 1649710880
Title
CRNP
Phone
(256) 325-2500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

8215 Madison Blvd Ste 130
Madison, AL 35758-2000

Mailing address

8215 Madison Blvd Ste 13
Madison, AL 35758-2017

Other identifiers 3

IdentifierTypeStateIssuer
1205874856OtherDORIS BELL
1649710880OtherKATY FRAZIER
1851942486OtherANGELA WALDROP

National Provider Directory

National Provider Directory

Locations

8215 Madison Blvd
Ste 13
Madison, AL 35758

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1730855768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8215 MADISON BLVD STE 13",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8215 MADISON BLVD STE 130",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582000",
            "telephone_number": "256-325-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PSYCHIATRY & BEHAVIORAL HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "COUSART",
        "authorized_official_first_name": "KATY",
        "authorized_official_title_or_position": "CRNP",
        "authorized_official_telephone_number": "256-325-2500"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORIS BELL",
            "identifier": "1205874856",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KATY FRAZIER",
            "identifier": "1649710880",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANGELA WALDROP",
            "identifier": "1851942486",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.