Healthcare Provider Details

I. General information

NPI: 1659880946
Provider Name (Legal Business Name): LIGHTHOUSE COUNSELING AND FAMILY RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 09/12/2025
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 GATEWAY DR STE 210
LINCOLN CA
95648
US

IV. Provider business mailing address

110 GATEWAY DR STE 210
LINCOLN CA
95648-3306
US

V. Phone/Fax

Practice location:
  • Phone: 916-645-3300
  • Fax: 916-645-3311
Mailing address:
  • Phone: 916-645-3300
  • Fax: 916-645-3311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT97103
License Number StateCA

VIII. Authorized Official

Name: DEBORAH DUELL-STEPHENS
Title or Position: CLINICAL DIRECTOR
Credential: LMFT
Phone: 916-408-6618