| Lighthouse Neurofeedback & Behavior Analysis, Inc. | |
|
720 100 Yearparty Ct Ste 200 Longmont CO 80504-8591 | |
| (720) 449-6676 | |
| (303) 374-5224 |
| Full Name | Lighthouse Neurofeedback & Behavior Analysis, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 720 100 Yearparty Ct Ste 200, Longmont, Colorado |
| Authorized Official Name and Position | Hui-chung Jacquelina King (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7633188088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Neurofeedback & Behavior Analysis, Inc. 720 100 Yearparty Ct Ste 200 Longmont CO 80504-8591 Ph: (720) 449-6676 | Lighthouse Neurofeedback & Behavior Analysis, Inc. 720 100 Yearparty Ct Ste 200 Longmont CO 80504-8591 Ph: (720) 449-6676 |
| NPI Number | 1477937522 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 07/10/2025 |
| Certification Date | 07/10/2025 |
| Medicare PECOS PAC ID | 5890220867 |
|---|---|
| Medicare Enrollment ID | O20241127002525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477937522 | NPI | - | NPPES |
| 9000153728 | Medicaid | CO |
| Provider Name | Alexandra Whiteley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336501428 PECOS PAC ID: 8921533902 Enrollment ID: I20241127002756 |
| Provider Name | Nicholas Adam Berger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932504198 PECOS PAC ID: 7517492457 Enrollment ID: I20241202000641 |
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