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Light Source Group LLC

Mental Health Clinic/Center (Including Community Mental Health Center) in Jacksonville, AR · enumerated 2024 · authorized official Sean Ronnau, Counselor.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1922832906

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Registry record

Entity type Organization (Type 2)
Legal business name Light Source Group LLC
Practice address 625 N 1st St Ste 200, Jacksonville, AR, 72076
Phone (501) 985-0292
Fax (501) 985-2070
Enumeration date Aug 30, 2024
Last updated in NPPES Jul 7, 2026

Taxonomy & classification

261QM0801X Mental Health Clinic/Center (Including Community Mental Health Center) Ambulatory Health Care Facilities Primary

Authorized official

Name Sean Ronnau
Title Counselor
Phone (501) 747-0232

Other identifiers

Identifier Type State Issuer
1093960411 Medicaid AR -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Light Source Group LLC?
The NPI for Light Source Group LLC is 1922832906, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Light Source Group LLC?
NPPES lists Sean Ronnau (Counselor) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-07-07.