| Lighthouse Professional Services Group, Llc | |
|
2102 7th St Columbus GA 31906-3606 | |
| (706) 392-5008 | |
| Not Available |
| Full Name | Lighthouse Professional Services Group, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2102 7th St, Columbus, Georgia |
| Authorized Official Name and Position | Sharmekia Lashon Fortson-hollis (FOUNDER/CEO/LPC) |
| Authorized Official Contact | 7063925008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Professional Services Group, Llc 54 Ryan Loop Phenix City AL 36869-7412 Ph: (706) 392-5008 | Lighthouse Professional Services Group, Llc 2102 7th St Columbus GA 31906-3606 Ph: (706) 392-5008 |
| NPI Number | 1003496167 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 04/13/2021 |
| Certification Date | 04/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003496167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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