Healthcare Provider Details

I. General information

NPI: 1609759901
Provider Name (Legal Business Name): LIGHTED PATH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2025
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 N MCKINLEY ST BLDG A
HENDERSON KY
42420-3687
US

IV. Provider business mailing address

3553 HENRYS WAY
HENDERSON KY
42420-9226
US

V. Phone/Fax

Practice location:
  • Phone: 364-643-1501
  • Fax: 270-826-2696
Mailing address:
  • Phone: 364-643-1501
  • Fax: 270-826-2696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: CIGI LYN YOUNG
Title or Position: OWNER/PROVIDER
Credential:
Phone: 364-643-1501