Healthcare Provider Details
I. General information
NPI: 1457286577
Provider Name (Legal Business Name): WINDOWLIGHTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3635 MANASSAS DR STE A
ROANOKE VA
24018-4031
US
IV. Provider business mailing address
PO BOX 254
DALEVILLE VA
24083-0254
US
V. Phone/Fax
- Phone: 540-774-4686
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMANTHA
FERNATT
Title or Position: SOLE MEMBER
Credential: LPC
Phone: 540-774-4686