Lighthouse Clinical Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LIGHTHOUSE CLINICAL COUNSELING, LLC

Practice address

3883 Rogers Bridge Road
Suite 601
Duluth, GA 30097

Phone

(770) 329-5405

NPI assigned

Sep 13, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Faithe Breanne Kimsey, MS, LPC, NCCNPI 1376025643

Title

Exective Dir/Ceoector

Phone

(770) 329-5405

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.

• Faithe Beanne Kimsey, MS, LPC, NCC

  • Professional Counselor
  • Duluth, GA
  • NPI 1376025643

  Professional

  NPD (past) Authorized official

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1982187068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 ROGERS BRIDGE ROAD",
            "address_2": "SUITE 601",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-329-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 ROGERS BRIDGE ROAD",
            "address_2": "SUITE 601",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-329-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE CLINICAL COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "KIMSEY",
        "authorized_official_first_name": "FAITHE",
        "authorized_official_middle_name": "BREANNE",
        "authorized_official_title_or_position": "EXECTIVE DIR/CEOECTOR",
        "authorized_official_telephone_number": "770-329-5405",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Duluth, GA
• Providers in Duluth, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.