Provider Demographics
NPI:1174334023
Name:LIGHTHOUSE THERAPY & ASSESSMENT SERVICES PLLC
Entity type:Organization
Organization Name:LIGHTHOUSE THERAPY & ASSESSMENT SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, ICST
Authorized Official - Phone:903-736-1028
Mailing Address - Street 1:2401 JUDSON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-4636
Mailing Address - Country:US
Mailing Address - Phone:469-334-3615
Mailing Address - Fax:
Practice Address - Street 1:2401 JUDSON RD STE 102
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-4636
Practice Address - Country:US
Practice Address - Phone:469-334-3615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty