Organization
LIGHTHOUSE MENTAL WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BANKS PMHNP-BC (PSYCHIATRIC NP/OWNER)
(781) 427-7070
Entity
Organization
Contact information
Practice address
28 RIVERSIDE DR STE 260, PEMBROKE, MA 02359-4947
(781) 472-7070
(781) 472-7071
Mailing address
28 RIVERSIDE DR STE 260, PEMBROKE, MA 02359-4947
(781) 427-7070
(781) 472-7071
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/18/2018
Last updated
01/13/2025
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