Healthcare Provider Details

I. General information

NPI: 1922980762
Provider Name (Legal Business Name): LIGHTHOUSE EDUCATION CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 CEDARCREST DR
FLORENCE AL
35630-1415
US

IV. Provider business mailing address

134 CEDARCREST DR
FLORENCE AL
35630-1415
US

V. Phone/Fax

Practice location:
  • Phone: 229-921-8975
  • Fax:
Mailing address:
  • Phone: 229-921-8975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ABBEY TAYLOR STAPLES
Title or Position: OWNER
Credential: BCBA, LBA
Phone: 229-921-8975