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General NPI Number Information
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NPI Number | 1811896350
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE CREATIVE ARTS THERAPY PLLC
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 22 LAKESIDE DR
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City | RONKONKOMA
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State | NY
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Zip | 11779-1950
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Country | US
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Telephone | 347-647-0559
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Fax |
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Provider Business Mailing Address
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Address Line | 22 LAKESIDE DR
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City | RONKONKOMA
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State | NY
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Zip | 11779-1950
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Country | US
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Telephone | 347-647-0559
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Fax |
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Authorized Official
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Title or Position | OWNER/ART THERAPIST
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Name | ELIZABETH MARIA MIGNANO
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Credential | LCAT ATR-BC
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Telephone | 347-647-0559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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