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General NPI Number Information
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NPI Number | 1144058009
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Entity Type | Organization
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Legal Business Name | NEW LIGHT MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 2047 CRISMAN RD
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City | PORTAGE
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State | IN
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Zip | 46368-1612
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Country | US
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Telephone | 317-565-7328
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2257
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City | CHESTERTON
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State | IN
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Zip | 46304-0357
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Country | US
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Telephone | 317-565-7328
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANCESCO ADAMO
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Credential | LMHC
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Telephone | 317-565-7328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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