Healthcare Provider Details

I. General information

NPI: 1154422764
Provider Name (Legal Business Name): LIGHT COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 LIGHT BLVD
FOREST VA
24551-5094
US

IV. Provider business mailing address

1075 LIGHT BLVD
FOREST VA
24551-5094
US

V. Phone/Fax

Practice location:
  • Phone: 434-384-1594
  • Fax: 434-384-3228
Mailing address:
  • Phone: 434-384-1594
  • Fax: 434-384-3228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE TAYLOR CASH
Title or Position: BILLING MANAGER
Credential:
Phone: 434-384-1594