Lighthouse Psychological Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIGHTHOUSE PSYCHOLOGICAL SERVICES, INC.

Practice address

1551 Payne Ave
Saint Paul, MN 55130-3218

Phone

(763) 780-3077

NPI assigned

Mar 19, 2008

Organization subpart

No

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

Authorized official

Name

Aaron J Trnka, M.A.

Title

Ceo

Phone

(763) 780-3307

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lighthouse Psychological Services Inc

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1548428170

  O20200115000170

  Same enrollment

Tax ID family

Lighthouse Psychological Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lighthouse Psychological Services Inc

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1548428170
  NPD tax ID

Locations

Practitioners 6

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

• Bryanna Garwood, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1013501485
  NPD
• Kelsey Lauren Nauman, LPCC

  • Mental Health Counselor
  • Fridley, MN
  • NPI 1538872346
  NPD
• Emily Heitman, LMFT

  • Marriage & Family Therapist
  • Fridley, MN
  • NPI 1609400134
  NPD (past)
• Catherine Marin, M.A., LMFT

  • Marriage & Family Therapist
  • Fridley, MN
  • NPI 1013387489
  NPD (past)
• Bailey Catherine Peterson, MA, LMFT

  • Marriage & Family Therapist
  • Mahtomedi, MN
  • NPI 1063995272
  NPD (past)
• Brittany Wiczek, MA, LMFT

  • Marriage & Family Therapist
  • Maple Grove, MN
  • NPI 1083248025
  NPD (past)

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1972774834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554211025",
            "telephone_number": "763-780-3307",
            "fax_number": "763-780-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PAYNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303218",
            "telephone_number": "763-780-3077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 3rd Ave NW",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550214219",
            "country_code": "US",
            "telephone_number": "507-720-8011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5155 E River Rd",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554211025",
            "country_code": "US",
            "telephone_number": "763-780-3307",
            "fax_number": "763-780-3306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIGHTHOUSE PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "TRNKA",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-780-3307",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP PROVIDER ID #",
            "identifier": "964912100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Lifson, LGSW
• Megan Lifto, APRN, CNS
• Julie Susanne Ligday, NP
• Nancee Michelle Light, LPN
• Lighthouse Psychological Services Inc
• Lighthouse Transit LLC
• Christopher S Lilja, DC
• Steven L Lillehaug, MD
• Theodore J Lillehei, M.D.
• Michelle Lillicrap, OTR

• Community/Behavioral Health Agency in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.