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General NPI Number Information
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NPI Number | 1003081001
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE COUNSELING CENTER, PC
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 629 N WASHINGTON HWY SUITE F
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City | ASHLAND
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State | VA
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Zip | 23005-1326
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Country | US
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Telephone | 804-798-1335
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Fax | 804-798-1909
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Provider Business Mailing Address
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Address Line | 629 N WASHINGTON HWY SUITE F
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City | ASHLAND
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State | VA
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Zip | 23005-1326
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Country | US
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Telephone | 804-798-1335
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Fax | 804-798-1909
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MS. BARBARA JEANNE SMITH
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Credential | LCSW
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Telephone | 804-798-1335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904001322
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License Number State | VA
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