Life and Light LLC

Primary specialty

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

Legal business name

LIFE AND LIGHT LLC

Practice address

5851 Cedar Lake Rd S Ste 201
Saint Louis Park, MN 55416-1481

Phone

(612) 399-9996

NPI assigned

May 28, 2020

Last updated

Jun 1, 2024By 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

Nikhil KaisthaNPI 1942681242

Title

Owner, LPCC

Phone

(612) 399-9996

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

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.

• Nikhil Kaistha, MS.ED, MA, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1942681242
  Medicare reassignment NPD Authorized official
• Christina Lee Goerdt, MSED, LPCC

  • Professional Counselor
  • St Louis Park, MN
  • NPI 1295621480
  Medicare reassignment NPD

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717200000000",
    "number": "1942824677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WOODDALE AVE S UNIT 18",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165162",
            "telephone_number": "612-399-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 CEDAR LAKE RD S STE 201",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554161481",
            "telephone_number": "612-399-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE AND LIGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-28",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A",
        "authorized_official_last_name": "KAISTHA",
        "authorized_official_first_name": "NIKHIL",
        "authorized_official_title_or_position": "OWNER, LPCC",
        "authorized_official_telephone_number": "612-399-9996"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Libi, M.A., LMFT
• Kay Elizabeth Lichtenberger, DPT
• Katie Marie Lick, R.D., L.D.
• Wayne D Liebhard, M.D.
• Jack L Liebo, M.D.
• Life Clinic Medical, PA
• Life Clinic, P.a.
• Life Medical, P.a. (Life Medical)
• Lifeclinic PA
• Lifeclinic Rehabilitation and Chiropractic

• Mental Health Clinic/Center (Including Community Mental Health Center) in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.