Healthcare Provider Details

I. General information

NPI: 1982207361
Provider Name (Legal Business Name): LANTERN'S LIGHT COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 E HOLLY AVE STE 107
PITMAN NJ
08071-1197
US

IV. Provider business mailing address

72 E HOLLY AVE STE 107
PITMAN NJ
08071-1197
US

V. Phone/Fax

Practice location:
  • Phone: 856-818-4477
  • Fax: 856-818-4477
Mailing address:
  • Phone: 856-818-4477
  • Fax: 856-818-4477

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: CHRISTOPHER IAN FRITZSCHE
Title or Position: OWNER
Credential: LCSW
Phone: 844-365-7676