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NPI 1215595236

NPI 1215595236 : LANTERN LIGHT COUNSELING, LLC : NORTH HAVEN, CT

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General NPI Number Information
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    NPI Number           |    1215595236
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    Entity Type          |    Organization 
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    Legal Business Name  |    LANTERN LIGHT COUNSELING, LLC 
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Dates
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    Enumeration Date     |    06/04/2019
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    Last Update Date     |    06/04/2019
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Provider Practice Location Address
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    Address Line         |    605 WASHINGTON AVE 
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    City                 |    NORTH HAVEN
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    State                |    CT
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    Zip                  |    06473-1123
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    Country              |    US
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    Telephone            |    203-767-5638
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    605 WASHINGTON AVE 
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    City                 |    NORTH HAVEN
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    State                |    CT
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    Zip                  |    06473-1123
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    Country              |    US
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    Telephone            |    203-767-5638
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DANIEL  BATTISTONI 
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    Credential           |    LPC
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    Telephone            |    203-767-5638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    
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    License Number State |    
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