Organization
LIGHTHOUSE WELLHEALTH INC
Active
Other names
Wellhealth Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE DECKER (CREDENTIALING MANAGER)
(480) 269-2971
Entity
Organization
Contact information
Practice address
4001 E BASELINE RD STE 204, GILBERT, AZ 85234-2743
(480) 269-2971
(480) 452-0691
Mailing address
70 S VAL VISTA DR STE A3-659, GILBERT, AZ 85296-1374
(480) 269-2971
(480) 452-0691
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/16/2022
Last updated
09/13/2022
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