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General NPI Number Information
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NPI Number | 1215363510
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE CENTER FOR THERAPY AND PLAY, LLC
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 13426 DAVENTRY WAY APT D
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City | GERMANTOWN
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State | MD
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Zip | 20874-2943
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Country | US
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Telephone | 240-554-5818
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Fax | 443-276-0905
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Provider Business Mailing Address
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Address Line | 13426 DAVENTRY WAY APT D
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City | GERMANTOWN
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State | MD
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Zip | 20874-2943
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Country | US
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Telephone | 240-554-5818
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Fax | 443-276-0905
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | YVETTE MIMI SNEED
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Credential | LCSW-C
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Telephone | 240-554-5818
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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 |
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License Number State |
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