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Organization
LEADING LIGHT MENTAL HEALTH CLINIC, INC
Active
Organization
LEADING LIGHT MENTAL HEALTH CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUAN Q ELLERBE LSW, LMHC, PSYD (OWNER)
(774) 220-4060
Entity
Organization
Contact information
Practice address
19 RIVERSIDE AVE, BROCKTON, MA 02301-6898
(774) 220-4060
Mailing address
500 WESTGATE DR # 1006, BROCKTON, MA 02301-1855
(774) 220-4060
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
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
08/09/2023
Last updated
09/17/2025
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