Light Source LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LIGHT SOURCE LLC

Practice address

114 E Lincoln St
Belleville, IL 62220-2251

Phone

(618) 444-9934

NPI assigned

Aug 27, 2019

Last updated

Aug 27, 2019By 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

Charles Franke

Title

LCSW/Owner

Phone

(618) 444-9934

Specialties & licenses 1

Addresses

Locations

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.

• Holly Deanne Gamroth

  • Clinical Social Worker
  • Belleville, IL
  • NPI 1659247476
  NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1902454689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E LINCOLN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622202251",
            "telephone_number": "618-444-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E LINCOLN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622202251",
            "telephone_number": "618-444-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT SOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "FRANKE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "LCSW/OWNER",
        "authorized_official_telephone_number": "618-444-9934"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barb M Leveling, PT
• Danielle C Lewis, SLP
• Ilene Castille Lewis, MD
• Latisha Shanta Lewis, M.A.T.
• Kathy Liefer, NURSE PRACTITIONER
• Hanna Jo Liljegren, PA-C
• Christine Lin, D.O.
• Lincoln Place Dental PC
• Lincoln Surgical Group
• Joanna Marie Lindauer, FNP-C

• Clinical Social Worker in Belleville, IL
• Providers in Belleville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.