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Organization
LIGHTHOUSE PSYCHIATRY & BEHAVIORAL HEALTH CLINIC LLC
Active
Organization
LIGHTHOUSE PSYCHIATRY & BEHAVIORAL HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATY COUSART (CRNP)
(256) 325-2500
Entity
Organization
Contact information
Practice address
8215 MADISON BLVD STE 130, MADISON, AL 35758-2000
(256) 325-2500
Mailing address
8215 MADISON BLVD STE 13, MADISON, AL 35758-2017
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205874856
DORIS BELL
—
01
—
1649710880
KATY FRAZIER
—
01
—
1851942486
ANGELA WALDROP
—
Enumeration date
08/19/2021
Last updated
01/31/2022
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