Healthcare Provider Details

I. General information

NPI: 1003649674
Provider Name (Legal Business Name): 8TH LIGHT ART THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 E MAIN ST
RICHMOND VA
23223-6960
US

IV. Provider business mailing address

2207 LUNDIE LN
HENRICO VA
23231-3934
US

V. Phone/Fax

Practice location:
  • Phone: 757-737-1875
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: LEILA SAADEH
Title or Position: OWNER
Credential: LPC, ATR-BC
Phone: 757-737-1875