Provider Demographics
NPI:1124867320
Name:LIGHTHOUSE THERAPIES, LLC
Entity type:Organization
Organization Name:LIGHTHOUSE THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:HOLGUIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:915-274-0372
Mailing Address - Street 1:4779 KERRY ANN PL
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7474
Mailing Address - Country:US
Mailing Address - Phone:915-274-0372
Mailing Address - Fax:
Practice Address - Street 1:4779 KERRY ANN PL
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-7474
Practice Address - Country:US
Practice Address - Phone:575-223-2449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health