Lighthouse Counseling of Vero Beach

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

MH14206 Issued in FL

Legal business name

LIGHTHOUSE COUNSELING OF VERO BEACH

Practice address

1705 19TH PL Ste a
Vero Beach, FL 32960-0686

Phone

(772) 321-8620

NPI assigned

Aug 16, 2016

Last updated

Aug 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Michal Andries, LMHC

Title

Owner

Phone

(772) 321-8620

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1740735117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 19TH PL STE A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600686",
            "telephone_number": "772-321-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 19TH PL STE A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600686",
            "telephone_number": "772-321-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE COUNSELING OF VERO BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "ANDRIES",
        "authorized_official_first_name": "MICHAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-321-8620",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "FL",
            "license": "MH14206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13848673",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.