Lighthouse Trauma Therapy LLC

NPI #1043925902 in Provo, Utah

Provider Information

NPI Number: 1043925902
Entity Type: Organization
Organization Name: Lighthouse Trauma Therapy LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Jan 16, 2023
Last Updated: Jan 16, 2023

Practice Location

Address: 883 S 1540 E
City: Provo
State: Utah
ZIP Code: 84606-6743
Phone: (801) 829-1311

Authorized Official

Name: AIMI CAMPBELL, LMFT
Title: OWNER
Phone: (801) 829-1311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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