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NPI Code Detail

MEDICARE: LIGHTHOUSE CONSULTING & THERAPEUTICS, PLLC

MEDICARE: LIGHTHOUSE CONSULTING & THERAPEUTICS, 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
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1619763570
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIGHTHOUSE CONSULTING & THERAPEUTICS, PLLC
Provider Business Mailing Address
First Line : 6943 BELTEAU LN
Second Line :
City : DALLAS
State : TX
Zip : 75227-1358
Country : US
Telephone Number : 515-520-0780
Fax Number :
Provider Business Practice Location Address
First Line : 3838 OAK LAWN AVE STE 1000
Second Line :
City : DALLAS
State : TX
Zip : 75219-4511
Country : US
Telephone Number : 972-643-8895
Fax Number :
Authorized Official
Title or Position : OWNER, PSYCHOLOGIST
Name : REED J. ROBINSON
Credential : PH.D., ABPP, MBA
Telephone Number : 515-520-0780
Provider Enumeration Date : 04/17/2025
Last Update Date : 04/17/2025

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