Healthcare Provider Details

I. General information

NPI: 1801708607
Provider Name (Legal Business Name): THE LIGHTHOUSE WELLNESS COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 BALTIMORE BLVD STE 402
WESTMINSTER MD
21157-6146
US

IV. Provider business mailing address

425 TANEY DR
TANEYTOWN MD
21787-2234
US

V. Phone/Fax

Practice location:
  • Phone: 301-254-2127
  • Fax:
Mailing address:
  • Phone: 301-254-2127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MELISSA KATLYN HOUCK
Title or Position: OWNER
Credential: LCPC
Phone: 301-254-2127