Healthcare Provider Details

I. General information

NPI: 1326784232
Provider Name (Legal Business Name): ARTHUR EUGENE LIGHTNER JR. CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

964 N MARKET ST
LISBON OH
44432-9363
US

IV. Provider business mailing address

PO BOX 464
LISBON OH
44432-0464
US

V. Phone/Fax

Practice location:
  • Phone: 330-424-1468
  • Fax:
Mailing address:
  • Phone: 330-424-1468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.175373
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: