Healthcare Provider Details

I. General information

NPI: 1497612956
Provider Name (Legal Business Name): LANTERN IN THE DARK HOLISTIC MENTAL HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6280 S MAIN ST STE 3
ASHTABULA OH
44004-4839
US

IV. Provider business mailing address

6280 S MAIN ST STE 3
ASHTABULA OH
44004-4839
US

V. Phone/Fax

Practice location:
  • Phone: 330-774-5883
  • Fax:
Mailing address:
  • Phone: 330-774-5883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAIGE BUTCHER
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: MSN, APRN, PMHNP-BC
Phone: 330-774-5883