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

Lighthouse Wellness Group

Organization Mental Health Counselor · NPI 1114739604

Lighthouse Wellness Group is a Mental Health Counselor in St Augustine, Florida. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1301 Plantation Island Dr S Ste 202A
St Augustine, FL 32080-3111
Phone: (904) 318-8500
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1114739604
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cooper Moore — Owner · (904) 318-8500
NPI enumeratedJanuary 22, 2025
Last updated in NPPESJanuary 31, 2025
Certification dateJanuary 31, 2025
Mailing address1301 Plantation Island Dr S Ste 202a, St Augustine, FL 32080-3111

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