Light Source Group LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LIGHT SOURCE GROUP LLC

Practice address

625 N 1St St Ste 200
Jacksonville, AR 72076-4117

Phone

(501) 985-0292

Fax

(501) 985-2070

NPI assigned

Aug 30, 2024

Organization subpart

No

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

Authorized official

Name

Sean Michael Ronnau, LPCNPI 1093960411

Title

Counselor

Phone

(501) 747-0232

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Sean Michael Ronnau, LPC

  • Professional Counselor
  • Jacksonville, AR
  • NPI 1093960411
  NPD Authorized official

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1922832906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W HICKORY ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764420",
            "telephone_number": "501-985-0292",
            "fax_number": "501-985-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N 1ST ST STE 200",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764117",
            "telephone_number": "501-985-0292",
            "fax_number": "501-985-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT SOURCE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-30",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "RONNAU",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "501-747-0232",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093960411",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lazora Lynette Leavy
• Legacy Housing Solutions Co.
• Michael T Leger, PTA
• Charles Mitchell Lewis, QBHP
• Meagan E. Lieber, M.S., CCC-SLP
• Lighthouse Academies of Arkansas
• Regina Renee Lilly
• Margaret McMenamy Lindley, PLMSW
• Melissa Liotta, BCBA
• Richard Joe Lisk, QBHP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.