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Organization
LIGHTHOUSE TRAUMA THERAPY LLC
Active
Organization
LIGHTHOUSE TRAUMA THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIMI CAMPBELL LMFT (OWNER)
(801) 829-1311
Entity
Organization
Contact information
Practice address
883 S 1540 E, PROVO, UT 84606-6743
(801) 829-1311
Mailing address
883 S 1540 E, PROVO, UT 84606-6743
(801) 829-1311
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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