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NPI Code Detail

MEDICARE: GUIDING LIGHT WELLNESS SERVICES

MEDICARE: GUIDING LIGHT WELLNESS SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1720663552
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUIDING LIGHT WELLNESS SERVICES
Provider Business Mailing Address
First Line : 419 BETHEL RD STE A
Second Line :
City : SOMERS POINT
State : NJ
Zip : 08244-2189
Country : US
Telephone Number : 609-968-4675
Fax Number : 609-904-5208
Provider Business Practice Location Address
First Line : 419 BETHEL RD STE A
Second Line :
City : SOMERS POINT
State : NJ
Zip : 08244-2189
Country : US
Telephone Number : 609-968-4675
Fax Number : 609-904-5208
Authorized Official
Title or Position : OWNER
Name : JAVIER GUZMAN
Credential : LCSW
Telephone Number : 609-968-4675
Provider Enumeration Date : 03/12/2021
Last Update Date : 03/12/2021

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Directions to “GUIDING LIGHT WELLNESS SERVICES ” Practice Location

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