LIGHTHOUSE PSYCHOLOGICAL SERVICES, LLC (NPI# 1356958672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356958672 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
630 Sw Nevada St Ste. E Poralnd OR 97219 |
| Mailing Address |
2800 N Lombard Street Ste. 153 Portland OR 97217 |
| Practice Telephone | 5418173824 |
| Practice Fax Number | 5033897945 |
| Mailing Telephone | 5418173824 |
| Mailing Fax Number | 5033897945 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | SARAH ECKSTEIN (OWNER) |
| Authorized Official Telephone | 5418173824 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LIGHTHOUSE PSYCHOLOGICAL SERVICES, LLC | 610 Sw Alder St Suite 320, Portland, OR 97205 |
| Street Address |
630 SW NEVADA ST STE. E |
| City | PORALND |
| State | OR |
| Zip Code | 97219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1548667918 | Eleven Eleven, LLC | Specialist/Technologist, Other | 6714 Sw 62nd Place, Portland, OR 97219 | 2014-12-01 |
| 1023414257 | Paul Shayne Hansen | Adult Companion | 9155 Sw 55th Avenue, Portland, OR 97219 | 2014-11-17 |
| 1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
| 1255749404 | Kristin Rae Paruszkiewicz | Physical Therapist | 7943 Sw Barbur Blvd #1, Portland, OR 97219 | 2014-07-31 |
| 1639436488 | Michelle Lorraine Emery | Counselor | 7912 Sw 35th, Portland, OR 97219 | 2012-04-18 |
| 1588930192 | Steve Ryan | Speech-Language Pathologist | 3315 Sw Falcon St, Portland, OR 97219 | 2012-03-28 |
| 1104145952 | Multnomah Family Care Center | Clinic/Center | 6787 Sw Capitol Hwy, Portland, OR 97219 | 2010-05-19 |
| 1740518331 | Trilbie L Patteson | Physical Therapy Assistant | 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 | 2009-11-20 |
| 1538307384 | Travis J. Elliott Nd LLC | Naturopath | 1340 Sw Bertha Blvd, Suite 200, Portland, OR 97219 | 2009-02-02 |
| Find all providers in zip 97219 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1407453889 | Larissa Catherine Miller | Psychologist | 2920 Alder St, Eugene, OR 97405-4146 | 2020-10-08 |
| 1619583408 | Kyleemillerphd | Psychologist | 586 Welcome Way Se, Salem, OR 97302-3932 | 2020-09-17 |
| 1740890771 | Marion David | Psychologist | 8228 Sw 171st Place, First Floor, Beaverton, OR 97007-6787 | 2020-08-04 |
| 1679182364 | Psychological Services of Pendleton, LLC | Psychologist | 1100 Southgate Ste 13, Pendleton, OR 97801-3973 | 2020-07-28 |
| 1497373021 | Jennifer Schmidt | Psychologist | 995 Stonewater Dr., Eagle Point, OR 97524 | 2020-07-09 |
| 1063039592 | Cyti Psychology LLC | Psychologist | 12205 Sw Tualatin Rd Ste 270, Tualatin, OR 97062-7623 | 2020-06-30 |
| 1811518434 | Nathaniel Israel | Psychologist | 7419 Se Woodstock Blvd, Portland, OR 97206-5838 | 2020-05-05 |
| 1477198315 | Emi Sumida Brown | Psychologist | 993 Nw Circle Blvd Ste A, Corvallis, OR 97330-1408 | 2019-11-14 |
| 1174166417 | Allyson Marie Taylor | Psychologist | 416 Laurel Ave Ste 1, Tillamook, OR 97141-2387 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.