| Lighthouse Psychiatry & Behavioral Health Clinic Llc | |
|
8215 Madison Blvd Ste 130 Madison AL 35758-2000 | |
| (256) 325-2500 | |
| Not Available |
| Full Name | Lighthouse Psychiatry & Behavioral Health Clinic Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 8215 Madison Blvd Ste 130, Madison, Alabama |
| Authorized Official Name and Position | Katy Cousart (CRNP) |
| Authorized Official Contact | 2563252500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Psychiatry & Behavioral Health Clinic Llc 8215 Madison Blvd Ste 13 Madison AL 35758-2017 Ph: () - | Lighthouse Psychiatry & Behavioral Health Clinic Llc 8215 Madison Blvd Ste 130 Madison AL 35758-2000 Ph: (256) 325-2500 |
| NPI Number | 1730855768 |
|---|---|
| Provider Enumeration Date | 08/19/2021 |
| Last Update Date | 01/31/2022 |
| Certification Date | 01/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730855768 | NPI | - | NPPES |
| 1205874856 | Other | DORIS BELL | |
| 1649710880 | Other | KATY FRAZIER | |
| 1851942486 | Other | ANGELA WALDROP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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