NPIMap

Organization Active NPI

Leading Light Mental Health Clinic, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
National Provider Identifier
1730862491
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LEADING LIGHT MENTAL HEALTH CLINIC, INC
Practice address
19 Riverside Ave
Brockton, MA 02301-6898
Phone
(774) 220-4060
NPI assigned
Aug 9, 2023
Last updated
Sep 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Dr. Guan Q Ellerbe, LSW, LMHC, PSYDNPI 1578993028
Title
Owner
Phone
(774) 220-4060

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

19 Riverside Ave
Brockton, MA 02301-6898

Mailing address

500 Westgate Dr # 1006
Brockton, MA 02301-1855
Phone (774) 220-4060

Other practice location 1

500 Westgate Dr # 1006
Brockton, MA 02301-1855
Phone (774) 220-4046

National Provider Directory

National Provider Directory

Locations

19 Riverside Ave
Brockton, MA 02301
Phone (508) 690-6069

74 Plain St
Unit De
Brockton, MA 02301

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1730862491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WESTGATE DR # 1006",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011855",
            "telephone_number": "774-220-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 RIVERSIDE AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016898",
            "telephone_number": "774-220-4060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Westgate Dr # 1006",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023011855",
            "country_code": "US",
            "telephone_number": "774-220-4046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEADING LIGHT MENTAL HEALTH CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "ELLERBE",
        "authorized_official_first_name": "GUAN",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-220-4060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LSW, LMHC, PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.