Organization
PHOENIX LIGHTHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAU SULLIVAN LMSW (CLINICAL DIRECTOR)
(317) 409-5755
Entity
Organization
Contact information
Practice address
5766 SOMERSET BLVD, BARGERSVILLE, IN 46106
(478) 279-9802
Mailing address
1710 KELLER PKWY # 2011, KELLER, TX 76248-3749
(478) 279-9802
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/20/2026
Last updated
04/30/2026
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