Healthcare Provider Details

I. General information

NPI: 1730295726
Provider Name (Legal Business Name): LIGHTHOUSE CHRISTIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 SUNBURY RD
COLUMBUS OH
43230-1136
US

IV. Provider business mailing address

5000 SUNBURY RD
COLUMBUS OH
43230-1136
US

V. Phone/Fax

Practice location:
  • Phone: 614-337-1986
  • Fax: 614-337-2936
Mailing address:
  • Phone: 614-337-1986
  • Fax: 614-337-2936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN JOHNSTON
Title or Position: DIRECTOR OF COUNSELING
Credential: LPCC-S
Phone: 614-337-1986