Healthcare Provider Details

I. General information

NPI: 1447178553
Provider Name (Legal Business Name): LIGHTWELL PSYCHOLOGY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

136 TAYLORS MILL CIR
PERRYSBURG OH
43551-6814
US

IV. Provider business mailing address

3454 OAK ALLEY CT STE 200
TOLEDO OH
43606-1370
US

V. Phone/Fax

Practice location:
  • Phone: 419-265-5413
  • Fax:
Mailing address:
  • Phone: 419-349-8321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM CHASE BARRON
Title or Position: CLINICAL PSYCHOLOGIST - OWNER
Credential: PSY.D.
Phone: 419-349-8321