| Lighthouse Center For Therapy & Play | |
|
6925 Oakland Mills Road Suite 206 Columbia MD 21045 | |
| (443) 864-5647 | |
| (443) 276-0905 |
| Full Name | Lighthouse Center For Therapy & Play |
|---|---|
| Speciality | Social Worker |
| Location | 6925 Oakland Mills Road, Columbia, Maryland |
| Authorized Official Name and Position | Yvette Mimi Ryans (OWNER/THERAPIST) |
| Authorized Official Contact | 4435353871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Center For Therapy & Play 6925 Oakland Mills Road Suite 206 Columbia MD 21045 Ph: (443) 864-5647 | Lighthouse Center For Therapy & Play 6925 Oakland Mills Road Suite 206 Columbia MD 21045 Ph: (443) 864-5647 |
| NPI Number | 1215363510 |
|---|---|
| Provider Enumeration Date | 09/18/2013 |
| Last Update Date | 01/17/2023 |
| Certification Date | 01/17/2023 |
| Medicare PECOS PAC ID | 6002048014 |
|---|---|
| Medicare Enrollment ID | O20140404001806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215363510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Yvette Ryans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396051181 PECOS PAC ID: 5991937906 Enrollment ID: I20140404001861 |
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