| Phoenix Lighthouse | |
|
5766 Somerset Blvd Bargersville IN 46106 | |
| (478) 279-9802 | |
| Not Available |
| Full Name | Phoenix Lighthouse |
|---|---|
| Speciality | Counselor |
| Location | 5766 Somerset Blvd, Bargersville, Indiana |
| Authorized Official Name and Position | Kamau Sullivan (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3174095755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Lighthouse 1710 Keller Pkwy # 2011 Keller TX 76248-3749 Ph: (478) 279-9802 | Phoenix Lighthouse 5766 Somerset Blvd Bargersville IN 46106 Ph: (478) 279-9802 |
| NPI Number | 1932057239 |
|---|---|
| Provider Enumeration Date | 03/20/2026 |
| Last Update Date | 06/09/2026 |
| Certification Date | 06/09/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932057239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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