Organization
LIGHTHOUSE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY MAHAIRAS MA, LMHC, BCBA (PRESIDENT/CLINICAL DIRECTOR)
(386) 492-9041
Entity
Organization
Contact information
Practice address
533 N NOVA RD STE 112, ORMOND BEACH, FL 32174-4420
(386) 492-9041
(386) 492-9061
Mailing address
533 N NOVA RD STE 112, ORMOND BEACH, FL 32174-4420
(386) 492-9041
(386) 492-9061
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104313500
—
FL
05
—
104796400
—
FL
Enumeration date
03/06/2017
Last updated
10/01/2024
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