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General NPI Number Information
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NPI Number | 1447178553
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Entity Type | Organization
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Legal Business Name | LIGHTWELL PSYCHOLOGY GROUP LLC
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 136 TAYLORS MILL CIR
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City | PERRYSBURG
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State | OH
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Zip | 43551-6814
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Country | US
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Telephone | 419-265-5413
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Fax |
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Provider Business Mailing Address
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Address Line | 3454 OAK ALLEY CT STE 200
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City | TOLEDO
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State | OH
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Zip | 43606-1370
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Country | US
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Telephone | 419-349-8321
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST - OWNER
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Name | WILLIAM CHASE BARRON
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Credential | PSY.D.
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Telephone | 419-349-8321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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