| Lighthouse Psychological Services, Pllc | |
|
9500 Ray White Rd Ste 200 Fort Worth TX 76244-9105 | |
| (817) 760-0349 | |
| Not Available |
| Full Name | Lighthouse Psychological Services, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9500 Ray White Rd Ste 200, Fort Worth, Texas |
| Authorized Official Name and Position | Nastassia Greer (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 8177600349 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Psychological Services, Pllc 9500 Ray White Rd Ste 200 Fort Worth TX 76244-9105 Ph: (817) 760-0349 | Lighthouse Psychological Services, Pllc 9500 Ray White Rd Ste 200 Fort Worth TX 76244-9105 Ph: (817) 760-0349 |
| NPI Number | 1003437997 |
|---|---|
| Provider Enumeration Date | 05/01/2020 |
| Last Update Date | 05/13/2020 |
| Certification Date | 05/13/2020 |
| Medicare PECOS PAC ID | 1153743331 |
|---|---|
| Medicare Enrollment ID | O20200616002065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003437997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Nastassia Shanae Toomer Greer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720597461 PECOS PAC ID: 8820344252 Enrollment ID: I20180627001979 |
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