| Lighthouse Psychologists Llc | |
|
2450 Hollywood Blvd Suite 200a Hollywood FL 33020-6619 | |
| (954) 667-7176 | |
| Not Available |
| Full Name | Lighthouse Psychologists Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2450 Hollywood Blvd, Hollywood, Florida |
| Authorized Official Name and Position | Patricia Jaegerman (OWNER) |
| Authorized Official Contact | 9546677176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Psychologists Llc 2450 Hollywood Blvd Suite 200a Hollywood FL 33020-6619 Ph: (954) 667-7176 | Lighthouse Psychologists Llc 2450 Hollywood Blvd Suite 200a Hollywood FL 33020-6619 Ph: (954) 667-7176 |
| NPI Number | 1598022451 |
|---|---|
| Provider Enumeration Date | 04/17/2012 |
| Last Update Date | 03/21/2016 |
| Medicare PECOS PAC ID | 5890093439 |
|---|---|
| Medicare Enrollment ID | O20160414000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598022451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY7141 (Florida) | Primary |
| Provider Name | Patricia Jaegerman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316272677 PECOS PAC ID: 6709184344 Enrollment ID: I20160414000439 |
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