Healthcare Provider Details

I. General information

NPI: 1265106025
Provider Name (Legal Business Name): LIGHTHOUSE COUNSELING ENTERPRISES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 SUGAR MAPLE CIR
LANSING MI
48917-8823
US

IV. Provider business mailing address

7605 SUGAR MAPLE CIR
LANSING MI
48917-8823
US

V. Phone/Fax

Practice location:
  • Phone: 517-420-1850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DAVID FROBISH
Title or Position: OWNER
Credential:
Phone: 517-420-1850