Healthcare Provider Details
I. General information
NPI: 1578225231
Provider Name (Legal Business Name): GUIDING LIGHT CHRISTIAN COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2021
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
383 COLLINS RD NE STE 110
CEDAR RAPIDS IA
52402-3147
US
IV. Provider business mailing address
1221 PARK PL NE STE A
CEDAR RAPIDS IA
52402-2019
US
V. Phone/Fax
- Phone: 319-382-8664
- Fax:
- Phone: 319-382-8664
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ALICIA
M
GERBER
Title or Position: CLINICALS THERAPIST/OWNER
Credential: LMHC
Phone: 319-382-8664