# LIGHTHOUSE MENTAL WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821564790
- **Authorized official:** BRIAN BANKS PMHNP-BC (PSYCHIATRIC NP/OWNER)
- **Authorized official phone:** (781) 427-7070

## Contact information

- **Practice address:** 28 RIVERSIDE DR STE 260, PEMBROKE, MA 02359-4947
- **Practice address phone:** (781) 472-7070
- **Practice address fax:** (781) 472-7071
- **Mailing address:** 28 RIVERSIDE DR STE 260, PEMBROKE, MA 02359-4947
- **Mailing address phone:** (781) 427-7070
- **Mailing address fax:** (781) 472-7071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2018
- **Last updated:** 01/13/2025