| Lighthouse Psychological Clinic, Pllc | |
|
52188 Van Dyke Ave Ste 300 Shelby Twp MI 48316-3575 | |
| (586) 244-8211 | |
| Not Available |
| Full Name | Lighthouse Psychological Clinic, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 52188 Van Dyke Ave Ste 300, Shelby Twp, Michigan |
| Authorized Official Name and Position | Jonathan Hart (PRESIDENT) |
| Authorized Official Contact | 5862448211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Psychological Clinic, Pllc 52188 Van Dyke Ave Ste 300 Shelby Twp MI 48316-3575 Ph: (586) 244-8211 | Lighthouse Psychological Clinic, Pllc 52188 Van Dyke Ave Ste 300 Shelby Twp MI 48316-3575 Ph: (586) 244-8211 |
| NPI Number | 1700501087 |
|---|---|
| Provider Enumeration Date | 10/10/2022 |
| Last Update Date | 10/10/2022 |
| Certification Date | 10/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700501087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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