NPIMap

Organization Active NPI

Lighthouse Neurofeedback & Behavior Analysis, Inc.

  • Behavior Analyst
  • Longmont, CO
National Provider Identifier
1972010064
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-09-5794
Legal business name
LIGHTHOUSE NEUROFEEDBACK & BEHAVIOR ANALYSIS, INC.
Practice address
1833 Sunset PL Ste a
Longmont, CO 80501-6545
Phone
(720) 449-6676
Fax
(303) 374-5224
NPI assigned
Jan 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Hui-Chung Jacquelina King
Title
Director of Operations
Phone
(720) 295-2291

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 0011628 CO
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-09-5794 Primary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

1833 Sunset PL Ste a
Longmont, CO 80501-6545

Mailing address

720 100 Yearparty CT Ste 200
Longmont, CO 80504-8591
Phone (720) 449-6676

Other practice location 1

1823 Sunset Pl Ste C
Longmont, CO 80501-6544
Phone (720) 449-6676

Other identifiers 1

IdentifierTypeStateIssuer
9000153728MedicaidCO

Other names 1

  • Lighthouse Neurofeedback & Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lighthouse Neurofeedback5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1833 Sunset Pl
Ste A
Longmont, CO 80501
Phone (720) 731-2312

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1972010064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 100 YEARPARTY CT STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805048591",
            "telephone_number": "720-449-6676",
            "fax_number": "303-833-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 SUNSET PL STE A",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016545",
            "telephone_number": "720-449-6676",
            "fax_number": "303-374-5224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1823 Sunset Pl Ste C",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805016544",
            "country_code": "US",
            "telephone_number": "720-449-6676",
            "fax_number": "303-374-5224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIGHTHOUSE NEUROFEEDBACK & BEHAVIOR ANALYSIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "HUI-CHUNG",
        "authorized_official_middle_name": "JACQUELINA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "720-295-2291"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0011628",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-09-5794",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000153728",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Neurofeedback & Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.