Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Light Source Group LLC

Organization Mental Health Clinic/Center (Including Community Mental Health Center) · NPI 1922832906

Light Source Group LLC is a Mental Health Clinic/Center (Including Community Mental Health Center) in Jacksonville, Arkansas. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

625 N 1st St Ste 200
Jacksonville, AR 72076-4117
Phone: (501) 985-0292
Fax: (501) 985-2070
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X

Record details

NPI number1922832906
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sean Ronnau — Counselor · (501) 747-0232
NPI enumeratedAugust 30, 2024
Last updated in NPPESJuly 7, 2026
Certification dateJuly 7, 2026
Mailing address116 W Hickory St, Jacksonville, AR 72076-4420

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