Healthcare Provider Details

I. General information

NPI: 1386500783
Provider Name (Legal Business Name): LIGHTHOUSE MENTAL HEALTH AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5161 DOGWOOD TRL
LYNDHURST OH
44124-2763
US

IV. Provider business mailing address

5161 DOGWOOD TRL
LYNDHURST OH
44124-2763
US

V. Phone/Fax

Practice location:
  • Phone: 216-272-7844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMY DOROD-GAUL
Title or Position: OWNER
Credential: LPCC-S
Phone: 216-272-7844