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Organization

LIGHTHOUSE FAMILY THERAPY PROF LLC

Active
Other names
LightHouse WholeHealth Family Center
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER N BERGIN (OWNER)
(303) 929-6743
Entity
Organization

Contact information

Practice address
1330 OAKRIDGE DR UNIT 105, FORT COLLINS, CO 80525-9651
(303) 929-6743
(970) 680-7250
Mailing address
1785 NIGHFALL DRIVE, WINDSOR, CO 80550
(303) 929-6743

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
174400000X
Specialist
Primary
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000218730
CO
Enumeration date
06/16/2023
Last updated
03/20/2026
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