MEDICARE: LIGHTHOUSE CHRISTIAN SERVICES

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	251V00000X	Voluntary or Charitable Agency
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1730295726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTHOUSE CHRISTIAN SERVICES

Provider Business Mailing Address
First Line	:	5000 SUNBURY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-1136
Country	:	US
Telephone Number	:	614-337-1986
Fax Number	:	614-337-2936

Provider Business Practice Location Address
First Line	:	5000 SUNBURY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-1136
Country	:	US
Telephone Number	:	614-337-1986
Fax Number	:	614-337-2936

Authorized Official
Title or Position	:	DIRECTOR OF COUNSELING
Name	:	STEVEN JOHNSTON
Credential	:	LPCC-S
Telephone Number	:	614-337-1986

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/16/2023

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