| Lighthouse Behavioral Health Center, Llc | |
|
8310 Midlothian Tpke North Chesterfield VA 23235-5163 | |
| (804) 447-6382 | |
| (804) 447-6383 |
| Full Name | Lighthouse Behavioral Health Center, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8310 Midlothian Tpke, North Chesterfield, Virginia |
| Authorized Official Name and Position | Robyn Lowry Jennings (CEO) |
| Authorized Official Contact | 8044476382 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Behavioral Health Center, Llc 8310 Midlothian Tpke North Chesterfield VA 23235-5163 Ph: (804) 447-6382 | Lighthouse Behavioral Health Center, Llc 8310 Midlothian Tpke North Chesterfield VA 23235-5163 Ph: (804) 447-6382 |
| NPI Number | 1982952545 |
|---|---|
| Provider Enumeration Date | 08/29/2012 |
| Last Update Date | 11/11/2021 |
| Certification Date | 11/11/2021 |
| Medicare PECOS PAC ID | 5092021949 |
|---|---|
| Medicare Enrollment ID | O20150908003108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982952545 | NPI | - | NPPES |
| Provider Name | Jennifer P Herrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972167674 PECOS PAC ID: 4587626858 Enrollment ID: I20041028001134 |
| Provider Name | Katy A Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225529209 PECOS PAC ID: 5799033635 Enrollment ID: I20180808003051 |
| Provider Name | Heather Cryer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689227597 PECOS PAC ID: 4880926088 Enrollment ID: I20191021001743 |
| Provider Name | Sarah Elizabeth Matalavage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770091944 PECOS PAC ID: 1254760325 Enrollment ID: I20200413000339 |
| Provider Name | Kylie Strogiy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497383095 PECOS PAC ID: 1759702525 Enrollment ID: I20200603000582 |
| Provider Name | Ashley N Marks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326640715 PECOS PAC ID: 6103230578 Enrollment ID: I20210126001240 |
| Provider Name | Antoinette Peace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558948042 PECOS PAC ID: 4789083270 Enrollment ID: I20210603002090 |
| Provider Name | Sage Miska |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669126207 PECOS PAC ID: 4183019573 Enrollment ID: I20220322001485 |
| Provider Name | Julia Merk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679227235 PECOS PAC ID: 4981099389 Enrollment ID: I20220322002047 |
| Provider Name | Scott Caravas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326782558 PECOS PAC ID: 3779960729 Enrollment ID: I20220513001238 |
| Provider Name | Brittany Reuschling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902385727 PECOS PAC ID: 1658758339 Enrollment ID: I20220518002120 |
| Provider Name | Samuel Matthew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982343216 PECOS PAC ID: 5193106896 Enrollment ID: I20220712003995 |
| Provider Name | Lindsey Hershner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699203141 PECOS PAC ID: 3072971092 Enrollment ID: I20230623001935 |
| Provider Name | Lori Franco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033577341 PECOS PAC ID: 1557710241 Enrollment ID: I20231206002608 |
| Provider Name | Laura Viles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841987237 PECOS PAC ID: 3870942071 Enrollment ID: I20231213002567 |
| Provider Name | Anna Ickes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053019901 PECOS PAC ID: 9537518675 Enrollment ID: I20231214000339 |
| Provider Name | Julia Willinger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063039246 PECOS PAC ID: 1850740994 Enrollment ID: I20231214000555 |
| Provider Name | Gabrielle Mormile |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679073894 PECOS PAC ID: 0244689396 Enrollment ID: I20231214000807 |
| Provider Name | Lauren Gibbs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568142784 PECOS PAC ID: 6204285364 Enrollment ID: I20231214001064 |
| Provider Name | Ashley Kulnis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336723980 PECOS PAC ID: 8123477288 Enrollment ID: I20231214001431 |
| Provider Name | Kevin Happeny |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578158994 PECOS PAC ID: 2567811649 Enrollment ID: I20231214002098 |
| Provider Name | Laura Chitty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396234423 PECOS PAC ID: 8921458316 Enrollment ID: I20231227002486 |
| Provider Name | Rachel Bonds |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619661907 PECOS PAC ID: 0042670705 Enrollment ID: I20240229003539 |
| Provider Name | Robyn Jennings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790054781 PECOS PAC ID: 9537475488 Enrollment ID: I20240315000051 |
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