MEDICARE: LIGHTED PATH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1134446958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTED PATH PLLC

Provider Business Mailing Address
First Line	:	PO BOX 224
Second Line	:	SUITE 250
City	:	CONWAY
State	:	AR
Zip	:	72033-0224
Country	:	US
Telephone Number	:	804-592-1205
Fax Number	:	866-388-8128

Provider Business Practice Location Address
First Line	:	1124 OAK ST
Second Line	:	SUITE 250
City	:	CONWAY
State	:	AR
Zip	:	72032-4318
Country	:	US
Telephone Number	:	804-592-1205
Fax Number	:	866-388-8128

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEREMY LYNN DICICCO
Credential	:	MA, LAC, CRC
Telephone Number	:	804-592-1205

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	07/09/2010

Similar Medicare Providers

1417684051 — IGH HOMECARE & CONCIERGE SOLUTIONS LLC
Practice Location Address:

1100 OAK ST STE 23
CONWAY, AR
72032-4318

Practice Phone: 501-205-0008
Practice Fax: 501-205-0008

1821989328 — JUANITA'S CARE
Practice Location Address:

1100 OAK ST # L2
CONWAY, AR
72032-4318

Practice Phone: 870-995-3320
Practice Fax: 501-500-5772

1972480945 — GENERATIONAL HEALTH OF ARKANSAS
Practice Location Address:

1100 OAK ST STE V27
CONWAY, AR
72032-4318

Practice Phone: 713-338-9901
Practice Fax: 713-338-9902

1174478614 — DR. JOSEPH MORRISON DC
Practice Location Address:

2221 WASHINGTON AVE
CONWAY, AR
72032-2765

Practice Phone: 501-205-8201
Practice Fax:

1295731891 — DR. CHARLES CLAYTON LAMEY JR. DC
Practice Location Address:

523 HARKRIDER ST
CONWAY, AR
72032-5631

Practice Phone: 501-327-4484
Practice Fax: 501-327-5963

1124025234 — DR. JIMMY SHAWN MCGEHEE D.C.
Practice Location Address:

523 HARKRIDER ST
CONWAY, AR
72032-5631

Practice Phone: 501-327-4484
Practice Fax: 501-327-5963

Directions to “LIGHTED PATH PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.