Organization
LIGHTHOUSETHERAPY, LLC
Active
Other names
LighthouseTherapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVAN MOORE (FOUNDER/OWNER)
(833) 749-3549
Entity
Organization
Contact information
Practice address
1777 S HARRISON ST STE 401, DENVER, CO 80210-3929
(833) 749-3549
(303) 376-4347
Mailing address
1777 S HARRISON ST STE 1200, DENVER, CO 80210-3955
(833) 749-3549
(303) 376-4347
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
01/14/2025
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