MEDICARE: LIGHT BEHAVIORAL HEALTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1437020302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHT BEHAVIORAL HEALTH, PLLC

Provider Business Mailing Address
First Line	:	1017 TURNPIKE ST STE 26A
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-2828
Country	:	US
Telephone Number	:	774-360-9899
Fax Number	:	774-209-4367

Provider Business Practice Location Address
First Line	:	1017 TURNPIKE ST STE 26A
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-2828
Country	:	US
Telephone Number	:	774-360-9899
Fax Number	:	774-209-4367

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OBIOMA LINDA OKEKE
Credential	:	PMHNP
Telephone Number	:	774-360-9899

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	02/19/2026

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