Provider Demographics
NPI:1972297463
Name:LIGHTHOUSE PSYCHOLOGY LLC
Entity type:Organization
Organization Name:LIGHTHOUSE PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LABB
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-208-4056
Mailing Address - Street 1:155 BERKELEY ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2637
Mailing Address - Country:US
Mailing Address - Phone:617-208-4056
Mailing Address - Fax:
Practice Address - Street 1:155 BERKELEY ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2637
Practice Address - Country:US
Practice Address - Phone:617-208-4056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty