Provider Demographics
NPI:1154035988
Name:LIGHTHOUSE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:LIGHTHOUSE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-850-9488
Mailing Address - Street 1:4006 S LONE PINE AVE UNIT 104
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6876
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6304 E 102ND ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-7120
Practice Address - Country:US
Practice Address - Phone:918-850-9488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty