Healthcare Provider Details

I. General information

NPI: 1265397756
Provider Name (Legal Business Name): FIRELIGHT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 WIN HENTSCHEL BLVD # 266
WEST LAFAYETTE IN
47906-4149
US

IV. Provider business mailing address

1337 WINDMILL DR
LAFAYETTE IN
47909-3763
US

V. Phone/Fax

Practice location:
  • Phone: 765-266-2640
  • Fax:
Mailing address:
  • Phone: 765-266-2640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER ADE
Title or Position: OWNER
Credential:
Phone: 765-266-2640